Rapid Push vs Pump-Infused Subcutaneous Immunoglobulin Treatment: a Randomized Crossover Study of Quality of Life in Primary Immunodeficiency Patients. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Immunology Année : 2018

Rapid Push vs Pump-Infused Subcutaneous Immunoglobulin Treatment: a Randomized Crossover Study of Quality of Life in Primary Immunodeficiency Patients.

Boris Bienvenu
  • Fonction : Auteur
Gregoire Cozon
  • Fonction : Auteur
Yves Mataix
  • Fonction : Auteur
Dominique Lachaud
  • Fonction : Auteur
Antoine Alix
  • Fonction : Auteur
Cyrille Hoarau
  • Fonction : Auteur
Daniel Antier
  • Fonction : Auteur
Sylvie Brice
  • Fonction : Auteur
Jean-Francois Viallard
  • Fonction : Auteur
Stephanie Tamisier
  • Fonction : Auteur
Anne-Laure Fauchais
  • Fonction : Auteur
Francoise Renon-Carron
  • Fonction : Auteur
Yann Fardini
  • Fonction : Auteur
Jean-Charles Crave
  • Fonction : Auteur
Pierre Miossec
  • Fonction : Auteur

Résumé

Purpose: Subcutaneous immunoglobulin replacement therapy (IgRT) may be administered once a week with a pump or every other day with a syringe (rapid push). The objective of the study was to compare the impact of pump and rapid push infusions on patient’s life quality index (LQI). Methods: This study was a randomized, crossover, multicenter, non-inferiority trial conducted in adults with primary immunodeficiency (PID) accustomed to weekly infusions at home by pump. Patients used pump or rapid push for 3 months each according to the randomized sequence. Main criterion was PID-LQI factor I (treatment interference). Non-inferiority ratio was set at 90%. Results: Thirty patients entered the study; 28 completed the two periods. IgRT exposure was similar during each period. At the end of each period, mean LQI factor 1 was 87.0 (IC95% [80.3; 94.3]) and 77.80 (IC95% [71.5; 84.7]) for pump and rapid push, respectively. There was a slightly larger effect of rapid push on treatment interference than with pump so that the primary endpoint could not be met. No difference was found on other LQI components, satisfaction (TSQM), or quality of life (SF36v2). Eight patients declared to prefer rapid push while 19 others preferred pump. Of rapid push infusions, 67.2% led to local reactions vs 71.8% of pump infusions (p = 0.11) illustrating its good tolerance. Rapid push and pump infusions achieved similar trough IgG levels with similar incidence of infections. Rapid push saved 70% of administration cost when compared to pump. Conclusions: Since IgRT is a lifelong treatment in PID patients, individualization of treatment is of paramount importance. Rapid push is a new administration method in the physician’s armamentarium which is preferred by some patients and is cost-effective.
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hal-04314174 , version 1 (05-12-2023)

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Boris Bienvenu, Gregoire Cozon, Yves Mataix, Dominique Lachaud, Antoine Alix, et al.. Rapid Push vs Pump-Infused Subcutaneous Immunoglobulin Treatment: a Randomized Crossover Study of Quality of Life in Primary Immunodeficiency Patients.. Journal of Clinical Immunology, 2018, Journal of Clinical Immunology, 38, pp.503-512. ⟨10.1007/s10875-018-0507-x⟩. ⟨hal-04314174⟩

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