Volume 10 Supplement 2

Canadian Society of Allergy and Clinical Immunology and AllerGen Abstracts 2014

Open Access

A pilot study of quality of life, mood, sleepiness and fatigue in patients with primary humoral immunodeficiency transitioning to subcutaneous immunoglobulin therapy

  • Persia Pourshahnazari1,
  • Gina Tsai2,
  • Adriana Martin3,
  • Amin Kanani3,
  • Donald Stark3 and
  • R Robert Schellenberg3
Allergy, Asthma & Clinical Immunology201410(Suppl 2):A37

https://doi.org/10.1186/1710-1492-10-S2-A37

Published: 18 December 2014

Background

Immunoglobulin replacement therapy is standard of care for patients with primary humoral immunodeficiency [1]. Compared with intravenous immunoglobulin (IVIG), subcutaneous immunoglobulin (SCIG) offers comparable efficacy, lower costs and reduced systemic reactions [2, 3]. However, little is known about effects on quality of life when patients transition from IVIG to SCIG. It was our objective to assess changes in quality of life, mood, sleepiness and fatigue in patients transitioning from IVIG to SCIG.

Methods

Adult patients with common variable immunodeficiency or X-linked agammaglobulinemia transitioning from IVIG to SCIG were invited to participate in this prospective, open-label, pilot study. At least one set of Short-Form 36 Health Survey (SF-36), Profile of Mood States (POMS), Epworth Sleepiness Scale (ESS) and nighttime sleep questionnaires was administered prior to the final IVIG infusion. These were repeated monthly for 3 months following the transition. Magnitude of change was estimated between IVIG trough and final SCIG steady-state data. Statistical significance was determined using linear mixed models for repeated measures with Kenward-Rogers correction.

Results

Twenty-seven patients were included in the analysis. Two of eight SF-36 quality of life domains showed significant improvement: role limitations due to physical health (p = 0.01) and emotional problems (p = 0.04). Two of six POMS mood subscales significantly improved: depression (p = 0.03) and anger (p = 0.04). One of six POMS mood subscales (tension, p = 0.08) and POMS total mood disturbance scores (p = 0.09) trended towards improvement. No significant changes were noted in ESS or nighttime sleepiness scores.

Conclusions

Patients transitioning from IVIG to SCIG for treatment of primary antibody immunodeficiency showed significant improvement in several quality of life and mood subscales. A larger study verifying these findings could encourage patients to switch to SCIG self-administration, producing quality of life benefits while decreasing health care costs.

Authors’ Affiliations

(1)
Department of Internal Medicine, University of British Columbia
(2)
Department of Medicine, Division of Allergy & Immunology, Schulich School of Medicine & Dentistry, Western University
(3)
Department of Medicine, Division of Allergy and Clinical Immunology, University of British Columbia

References

  1. Chapel HM: Consensus panel for the diagnosis and management of primary antibody deficiencies: consensus on diagnosis and management of primary antibody deficiencies. Br Med J. 1994, 308: 581-585. 10.1136/bmj.308.6928.581.View ArticleGoogle Scholar
  2. Abolhassani H, Sadaghiani MS, Aghamohammadi A, Ochs HD, Rezaei N: Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: systematic review and meta analysis. J Clin Immunol. 2012, 32 (6): 1180-92. 10.1007/s10875-012-9720-1.View ArticlePubMedGoogle Scholar
  3. Ho C, Membe S, Cimon K, Roifman C, Kanani A, Morrison A: Subcutaneous versus intravenous immunoglobulin for primary immunodeficiencies: systematic review and economic evaluation. Technology report number 98. 2008, Ottawa: Canadian Agency for Drugs and Technologies in HealthGoogle Scholar

Copyright

© Pourshahnazari et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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