Subcutaneous immunoglobulin replacement therapy for primary antibody deficiency: advancements into the 21st century

Objectives: To provide a review of the world literature and discuss the clinical role of subcutaneous immunoglobulin (SCIG) therapy for primary antibody deficiency. Data Sources: English-language publications on SCIG therapy were identified through MEDLINE and through the reference list of the initially identified publications. Study Selection: Articles pertaining to SCIG for the treatment of immunodeficiency, particularly primary antibody deficiency, were selected. Results: SCIG therapy has been shown to be effective and safe for the treatment of primary immunodeficiency. The risk of systemic reactions during infusion is generally reported to be less than 1%. Many patients prefer SCIG over conventional intravenous immunoglobulin therapy because of increased convenience and independence associated with SCIG therapy. Publications show SCIG therapy to be advantageous in selected patient populations, such as children, pregnant women, and patients with poor intravenous access. Conclusion: SCIG therapy has been widely used in some European countries for a number of years, but a Food and Drug Administration-approved product was only recently introduced into the United States in 2006. SCIG therapy offers unique advantages that are applicable to many patients receiving immunoglobulin therapy for primary immunodeficiency.