Comparison of side effect rates between IVIG and SCIG in a tertiary neurology centre

Rogers, Tobias and White, Laura and Keh, Ryan Yann and Smith, Hannah and Cooper, Susan and Gosal, David (2024) Comparison of side effect rates between IVIG and SCIG in a tertiary neurology centre. Journal of Neurology, Neurosurgery and Psychiatry, 95 (Suppl.): 123. ISSN 0022-3050

Abstract

Background Intravenous immunoglobulin (IVIg) and subcutaneous immunoglobulin (SCIg) are used in the management of various neuroinflammatory conditions. IVIG is associated with potentially serious side effects (SEs), in particular venous thromboembolic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE), and arterial thromboembolic events such as myocardial infarction (MI) and stroke. SCIg may represent a safer alternative for patients who are at risk of thromboembolic events. Methods Our aim is to compare the safety profiles of SCIg and IVIg using a large cohort of patients treated at a single large neurosciences centre, with over 15 years of SCIg experience. Side effects (SEs) during treatment will be collated from the electronic patient record and compared between treatment cohorts, along with data on demographics, history of thromboembolic events, indication for immunoglobulin, dosing, and reasons for treatment cessation. Results Data collected thus far for 117 patients treated with SCIg showed that the commonest SE was skin erythema/rash (27/117, 23.1%). MI and DVT were experienced by one patient each (0.9%); no patient experienced a PE or stroke. Event rates for venous and arterial thromboembolism were both 0.3 per 100 person-years. Data collection for the IVIg cohort is almost complete and will be presented in full. Conclusions Thromboembolic event rates were very low in patients treated with SCIG compared with published data for IVIG.