Table 1.

Differences between routes of administration

	Intravenous immunoglobulin (IVIg)	Subcutaneous immunoglobulin (SCIg)	Facilitated subcutaneous immunoglobulin (fSCIg) with 10% IVIg using 75 U/g rHuPH20	Facilitated subcutaneous immunoglobulin (fSCIg) with 16% SCIg using 50 U/g ovine hyaluronidase	Rapid push
Venous access	Yes	No	No	No	No
Maximum infusion rate	300 mL/hour	40 mL/hour	160–300 mL/hour	100 mL/hour	1–2 mL/minute
Maximal volume	NA	40 mL/site	Up to 716 mL/site	100–200 mL/site	20 mL
Maximal dose/hour	30 g	6.4–8 g/site	16–30 g	16 g	NA
Home therapy	Yes	Yes	Yes	Yes	Yes
Infusion time per month (IVIg every 3 weeks)	2.9 hours	5–6 hours	2.7 hours	3–4 hrs (fortnightly dosing)	3–6 hrs
Training time for home	4–6 sessions over 3–6 months	4–6 sessions over 1–6 weeks	4–6 sessions over 2–6 months	4–6 sessions over 2–6 months	4 sessions over 4 days
Minimum required hyaluronidase dose	NA	NA	75 U/g	50 U/g	NA
Bioavailability	100%	67%	92%	Likely similar to 92% (not studied)	Likely similar to 67%
Peak/trough variation	Large	Minor (slightly more with fortnightly dosing)	Intermediate, dependent on treatment interval	Intermediate, dependent on treatment interval	Negligible
High-dose immunoglobulin	Yes	Requires multiple sites	Yes – not yet studied	Yes, equivalent monthly dose achieved	No – not studied
Pump requirement	No	Yes	Yes, high volume	Yes, high volume	No

Notes: The values for fSCIg are based on published studies,³⁵,³⁶ and calculations have been made assuming a 3-week interval between intravenous or recombinant human hyaluronidase (rHu)-PH20 facilitated infusions of a 70 kg patient receiving 0.5 g/kg/month. The training times reflect four to six training sessions spaced 3–4 weeks apart for IVIg and weekly for SCIg. There will however be variation between individuals and practice in different centers. Adapted by permission from BMJ Publishing Group Limited. Journal of Clinical Pathology, Knight E, Carne E, Novak B, et al., 63(9), 846-847, 2010.

Abbreviation: NA, not applicable.