Subcutaneous immunoglobulin: opportunities and outlook
Subcutaneous immunoglobulin: opportunities and outlook
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DOI：
10.1111/j.1365-2249.2009.04027.x
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发表时间：
2009-12-01
影响因子：
4.6
通讯作者：
Ochs, H. D.
中科院分区：
文献类型：
--
作者：
Misbah, S.;Sturzenegger, M. H.;Ochs, H. D.
P>；免疫球蛋白(Ig)皮下注射(S.C.)近年来，Route变得越来越受欢迎。该方法不需要静脉途径，几乎没有全身副作用，据报道可以改善患者的生活质量。目前对其使用的一个限制是需要管理的大容量。由于组织无法接受如此大的体积，因此需要在多个部位频繁给药。到目前为止进行的大多数研究都调查了皮下免疫球蛋白(SCIg)在以前静脉注射治疗的患者中的使用情况。配方。新数据现在支持S.C.的使用。给药之前未经治疗的原发免疫缺陷患者。SCIg治疗可能进一步有益于自身免疫性神经疾病的治疗，如多灶性运动神经病；然而，直接比较S.C.和静脉注射。对于此指示，仍需执行路线。新的发展可能会进一步改善和促进S.C.管理路线。例如，透明质酸酶促进的给药增加了SCIg的生物利用度，并可能允许在单个部位给药更大的体积。或者，更集中的配方可以减少给药所需的体积，快速推送技术可能允许更短的给药时间。随着这些发展转化为临床实践，更多的医生和患者可能会选择S.C.未来的施政路线。
P>Immunoglobulin (Ig) administration via the subcutaneous (s.c.) route has become increasingly popular in recent years. The method does not require venous access, is associated with few systemic side effects and has been reported to improve patients' quality of life. One current limitation to its use is the large volumes which need to be administered. Due to the inability of tissue to accept such large volumes, frequent administration at multiple sites is necessary. Most studies conducted to date have investigated the use of subcutaneous immunoglobulin (SCIg) in patients treated previously with the intravenous (i.v.) formulation. New data now support the use of s.c. administration in previously untreated patients with primary immunodeficiencies. SCIg treatment may further be beneficial in the treatment of autoimmune neurological conditions, such as multi-focal motor neuropathy; however, controlled trials directly comparing the s.c. and i.v. routes are still to be performed for this indication. New developments may further improve and facilitate the s.c. administration route. For example, hyaluronidase-facilitated administration increases the bioavailability of SCIg, and may allow for the administration of larger volumes at a single site. Alternatively, more concentrated formulations may reduce the volume required for administration, and a rapid-push technique may allow for shorter administration times. As these developments translate into clinical practice, more physicians and patients may choose the s.c. administration route in the future.