Transitioning Patients From IVIg to SCIg in CIDP

Author(s):

Panelists discuss how transitioning stable patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from intravenous immunoglobulin (IVIg) to subcutaneous immunoglobulin (SCIg) can offer greater convenience and independence, with careful consideration of dosing, patient education, and ongoing monitoring to ensure successful treatment outcomes.

EP: 1.Overview of CIDP

EP: 2.Diagnosis of CIDP

EP: 3.Impact of CIDP on Quality of Life and Importance of Early Intervention

EP: 4.CIDP Treatment Options and Treatment Selection Criteria

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EP: 5.Transitioning Patients From IVIg to SCIg in CIDP

EP: 6.Efgartigimod for Treatment of CIDP

Summary for Physicians:

This segment discusses the approach to transitioning patients with CIDP from IVIg to SCIg, including key considerations and best practices.

Key Points:

1. Transitioning From IVIg to SCIg: Transitioning patients from IVIg to SCIg is often considered for patients who are clinically stable on IVIg but seek more convenient treatment options, particularly for home-based therapy. The approach includes:

Ensuring Clinical Stability: Patients should be stable on IVIg therapy with controlled symptoms before transitioning.
Dose Conversion: The dose of SCIg is typically calculated based on the patient’s prior IVIg dose, adjusting for pharmacokinetic differences between the 2 formulations. A conversion factor may be used to ensure that the SCIg dose provides equivalent therapeutic levels.
Initial Supervised Transition: The first few SCIg infusions should be monitored in a clinical setting to ensure efficacy and to address any potential issues with infusion-related reactions.
Patient Education: Proper education on self-administration is crucial for SCIg therapy, especially for patients transitioning from IVIg. This includes teaching injection techniques, recognizing potential adverse effects, and understanding how to manage home infusions.

2. Factors to Consider in Transition:

Patient Preference: SCIg allows for home administration, which can enhance patient independence and convenience.
Treatment Efficacy and Tolerability: Some patients may prefer SCIg if they experience challenges with IVIg infusions, such as difficult vein access or inconvenience of frequent hospital visits.
Monitoring: Transition should be followed by regular monitoring to ensure sustained therapeutic effects and to adjust doses if needed.

In summary, transitioning from IVIg to SCIg is a well-established approach for patients who are stable on IVIg and prefer a more flexible, home-based treatment. Proper management of dosing, patient education, and follow-up are key to ensuring a successful transition and continued disease control.