Background Both intravenous and subcutaneous human immune globin G (IgG) replacement (IVIG and SCIG, respectively) reduce severe infection and increase serum IgG levels in primary immune deficiency disorder (PIDD) patients who require replacement. SCIG can be administered either with the aid of an infusion pump, or by patients or caregivers themselves, using butterfly needles and a syringe ("SCIG push"). SCIG offers advantages over IVIG, including higher steady state IgG levels, improved patient quality of life indicators, and decreased cost to the healthcare system, and for these reasons, SCIG has been increasingly used in Manitoba starting in 2007. We sought to determine the effectiveness of SCIG push in our local adult PIDD population. Methods We conducted a retrospective chart review of all adult patients enrolled in the SCIG push program in Manitoba, Canada from its inception in November 2007 through September 2018. We included patients who were naïve to IgG replacement prior to SCIG, and those who had received IVIG immediately prior. We collected data regarding serum IgG levels, antibiotic prescriptions, hospital admissions, and adverse events during a pre-defined period prior to and following SCIG initiation. Statistical significance was determined via two-tailed t-test. Results 62 patients met inclusion criteria, of whom 35 were on IVIG prior and 27 were IgG replacement naïve. SCIG push resulted in an increase in serum IgG levels in those naïve to IgG replacement, as well as in those who received IVIG prior. SCIG push also resulted in a statistically significant reduction in number of antibiotic prescriptions filled in the naïve subgroup, and no significant change in antibiotics filled in the IVIG prior group. 8/62 PIDD patients (12.9%) left the SCIG program during our review period for varying reasons, including side-effects. Conclusions In a real-life setting, in the Manitoba adult PIDD population, SCIG push is an effective method of preventing severe infections, with most patients preferring to continue this therapy once initiated.

中文翻译：

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马尼托巴省原发性免疫缺陷患者通过快速“推式”输注提供皮下免疫球蛋白：回顾性研究。

背景 静脉内和皮下人免疫球蛋白 G (IgG) 替代物（分别为 IVIG 和 SCIG）可减少需要替代物的原发性免疫缺陷病 (PIDD) 患者的严重感染并增加血清 IgG 水平。SCIG 可以借助输液泵给药，也可以由患者或护理人员自己使用蝶形针和注射器给药（“SCIG push”）。SCIG 提供优于 IVIG 的优势，包括更高的稳态 IgG 水平、改善的患者生活质量指标以及降低医疗保健系统的成本，出于这些原因，从 2007 年开始，SCIG 已越来越多地用于曼尼托巴省。我们试图确定有效性SCIG 推动我们当地的成人 PIDD 人口。方法 我们对从 2007 年 11 月到 2018 年 9 月在加拿大马尼托巴省参加 SCIG 推送计划的所有成年患者进行了回顾性图表审查。我们纳入了在 SCIG 之前未接受过 IgG 替代的患者，以及接受过 IVIG 的患者紧接在前。我们在 SCIG 开始之前和之后的预定义期间收集了有关血清 IgG 水平、抗生素处方、住院和不良事件的数据。通过双尾 t 检验确定统计学显着性。结果 62 名患者符合纳入标准，其中 35 名先前接受过 IVIG，27 名未接受过 IgG 替代治疗。SCIG 推动导致未接受 IgG 替代治疗的患者以及之前接受 IVIG 的患者血清 IgG 水平升高。SCIG 推动还导致初始亚组中填写的抗生素处方数量在统计学上显着减少，而 IVIG 先前组中填写的抗生素没有显着变化。8/62 名 PIDD 患者 (12.9%) 在我们的审查期间出于各种原因（包括副作用）离开了 SCIG 计划。结论 在现实生活中，在曼尼托巴省成人 PIDD 人群中，SCIG 推送是预防严重感染的有效方法，大多数患者更愿意在开始后继续这种治疗。