TABLE 3.
Example CIDP candidates for IVIg
| Potential IVIg candidate examplesa | Considerations to discuss with patient |
|---|---|
| Patient lacking organizational skill or drive to self‐administer | Some patients may be unwilling, or lack the skills, necessary to take on an element of their own disease management. Setting appropriate patient expectations when discussing SCIg is important to outline the responsibilities of self‐administration and to help assess whether the patient would derive more benefit from an HCP‐assisted mode of administration |
| Patient unable to self‐administer due to poor dexterity, fear of needles or no reliable support network | Patients with poor manual dexterity or fear of needles may struggle with aspects of the self‐administration technique (drawing solution from vial into syringe, etc.). A reliable caregiver (eg, spouse, family member, or friend) nearby to provide support or assist with the infusion can be considered if available. The use of a SCIg pre‐filled syringe to simplify the process can also be an option. In the absence of the above options, remaining on IVIg may be a more appropriate plan |
| Patient preferring treatment in a clinic setting or administered by an HCP | Some patients may prefer a clinic setting for their infusions due to the confidence and relationships built with staff. IVIg has the advantage of access to laboratory testing at the time of initiating the IV line. There is also potentially less risk of dosing errors in treatment administered by an HCP and the reliance on an HCP to monitor for side effects |
| Patient familiarity and extensive history with IVIg | For established patients with CIDP, they may have received IVIg for a long time and feel comfortable with a therapy they know and trust. Patients may not get as much subjective benefit from SCIg compared with IVIg due to the route of administration and slower absorption. Physicians should periodically reassess the patient's perception of SCIg as the attributes which did not initially appeal may be viewed more favorably with changing patient circumstances |
| Patient preferring more infrequent infusions | Some patients may find the infrequent infusion schedule (and potentially fewer disease reminders) associated with IVIg every 3 or more weeks fits in better with their lifestyle. As above, periodic discussions on the most suitable mode of administration should take place to reflect changing circumstances |
| Low BMI patients requiring large IgG doses | Self‐administration of large volumes of SCIg may be unappealing or challenging for low BMI patients who have less available subcutaneous tissue for infusions. Often a SCIg infusion regimen can be designed to accommodate these patients, but this may require a higher number of infusion sites |
Abbreviation: BMI, body mass index.
a
Table does not provide an exhaustive list of potential candidates, but rather highlights some of the considerations to factor in during discussions with patients.