Safety, efficiency, and treatment satisfaction in children with primary immunodeficiency receiving subcutaneous immunoglobulin treatment

OBJECTIVE: Patients with Inborn Errors of Immunity, also known as Primary Immunodeficiency (PID), are prone to recurrent bacterial infections and these patients often require lifelong IgG replacement therapy. The aim of this presentation is to evaluate the efficacy, safety, and patient satisfaction in PID patients receiving subcutaneous immunoglobulin (SCIG) treatment and to share our expe-riences.
METHODS: Twenty-one patients who were followed up with the diagnosis of PID by our Pediatric Allergy and Immunology Clinic and received regular intravenous immunoglobulin therapy (IVIG) befo-re starting SCIG treatment were included in the study.
RESULTS: A total of 21 patients were included in the study. 10 of the patients (47.6%) were female, 11 (52.4%) were male, and the mean age was 8.8±4.42 years. Five of the patients were Syrian patients living in the refugee camp. Threshold IgG levels of the patients were evaluated every 3 months. IgG levels were significantly higher than baseline IVIG levels at weeks 3, 6, and 12 of SCIG treatment, respectively. There was no significant difference between 3rd, 6th and 12th months of SCIG treatment. A statistically significant decrease was observed in the frequency of infections in patients who received SCIG treatment (p=0.003). During SCIG treatment, the total infection rate was 4.1/person/year. According to the TSQM-9 satisfaction questionnaire, the annual hospitalization rate was 0.9/patient/year for IVIG and 0.4/patient/year for SCIG (p>0.005), and 61.9% of patients were moderately satisfied, 14.2%. 19% were very satisfied and 4.7% were not satisfied with the treatment. When the satisfaction criteria were evaluated, it was observed that the patients mostly (71%) were satisfied with the absence of vascular access prob-lems and the comfort of self-application at home.
CONCLUSION: SCIG therapy causes high serum IgG levels and a reduced frequency of infections and can be a safe, effective, and well-tolerated treatment alternative in patients with PID with high patient satisfaction.

Subkutan Ýmmünoglobulin Tedavisi Alan Primer Ýmmün Yetmezlikli Çocuklarda Güvenlik, Etkinlik ve Tedavi Memnuniyeti

Giriþ Primer Ýmmün Yetmezlik (PÝY) olarak da bilinen Doðuþtan Ýmmünite Kusurlarý olan hasta-lar, tekrarlayan bakteriyel enfeksiyonlara eðilimlidir ve bu hastalar genellikle ömür boyu IgG replasman tedavisi gerektirir. Bu sunumun amacý, subkutan immünoglobulin (SKÝG) tedavisi alan PID hastalarýnda etkinlik, güvenlik ve hasta memnuniyetini deðerlendirmek ve deneyimleri-mizi paylaþmaktýr. Yöntemler Pediatrik Alerji ve Ýmmünoloji Kliniðimiz tarafýndan PÝY tanýsýný ile izlenen ve SKÝG tedavisine geçmeden önce düzenli intravenöz immünoglobulin tedavisi (ÝVÝG) alan 21 hasta çalýþmaya dahil edildi. Bulgular Çalýþmaya toplam 21 hasta dahil edildi. Hastalarýn 10'u (% 47,6) kadýn, 11'i (% 52,4) erkek ve yaþ ortalamasý 8,8±4,42 yýl idi. Hastalar-dan beþi, mülteci kampýnda yaþayan Suriyeli hastalardý. Hastalarýn eþik IgG düzeyleri, 3 ayda bir deðerlendirildi. SKÝG tedavisinin 3, 6 ve 12. haftalarýnda IgG seviyeleri, sýrasýyla baþlangýç ÝVÝG seviyelerinden önemli ölçüde daha yüksekti, SKÝG tedavisinin 3, 6 ve 12. aylarý arasýnda anlamlý bir fark yoktu. SKÝG tedavisi alan hastalarda enfeksiyon sýklýðýnda istatistiksel olarak anlamlý azalma gözlendi (p: 0,003). SKÝG tedavisi süresince toplam enfeksiyon oraný kiþi baþýna yýlda 4,1 idi. TSQM-9 memnuniyet anketine göre, yýllýk hastaneye yatýþ oraný ÝVÝG için hasta baþýna yýlda 0,9 ve SKÝG için hasta baþýna yýlda 0,4 idi (p> 0,005) ve hastalarýn % 61,9'u tedaviden memnun, % 14,2'si biraz memnun,% 19'u çok memnun ve % 4,7'si memnun deðildi. Memnuni-yet kriterleri deðerlendirildiðinde, hastalarýn en çok (% 71) damar yolu problemlerinin olmamasý ve evde kendi kendine uygulama yapabilme rahatlýðýndan memnun olduklarý görüldü. Tartýþma SKÝG tedavisi, yüksek serum IgG seviyelerine, azalmýþ enfeksiyon sýklýðýna neden olur ve yük-sek hasta memnuniyeti ile PÝYli hastalarda güvenli, etkili ve iyi tolere edilen bir tedavi alternatifi olabilir. (NCI-2020-0331.R1)