A Comparative Study of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin in Adult Patients with Primary Immunodeficiency Diseases: A Systematic Review and Meta-Analysis

ABSTRACT

Subcutaneous immunoglobulin (SCIG) is a new therapeutic procedure for patients with primary immunodeficiency (PI). This research is a systematic review of studies on the efficacy and safety of intravenous immunoglobulin (IVIG) and SCIG in adult patients with PI. This study includes a systematic review of cohorts and randomized clinical trials (24 articles) from 5 databases with no time limits. Random effects meta-analysis was performed for outcomes such as efficacy and safety. Standard mean difference (SMD) of serum immunoglobulin level was equal to 0.336 (P <0.01; 0.205-0.467) and the odds ratio (OR) of side effects was 0.497 (P=0.1; 0.180-1.371). The results indicate that SCIG leads to a higher level of immunoglobulin and a reduction in side effects but shows the same infection rate as IVIG. Our analysis shows that shifting from IVIG to SCIG therapy can have clinical benefits for PI patients.

KEYWORDS:

• Subcutaneous immunoglobulin
• Intravenous immunoglobulin
• primary immunodeficiency
• efficacy
• safety

Acknowledgements

The authors would like to express their sincere thanks to the numerous reviewers for their valuable help. We would like to extend our gratitude to Dr Hassan Abolhassani and Dr Mohamadreza Mobinizadeh for this guidance and encouragement for this article.

Financial and competing interests disclosure

This work was supported by Iran University of Medical Science (IUMS/SHMIS_2015/7). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

^1. Preferred Reporting Items for Systematic Reviews.