Home Self-Administration of Intravenous Immunoglobulin Therapy in Children

Twelve children with primary immunodeficiency aged 2 to 17 years (mean ± 1 SD = 9.8 ± 5.3), were enrolled in a 9-month study to evaluate the feasibility and safety of home self-infusion of intravenous immunoglobulin (IVIg). An initial 2-month training and supervisory period was followed by a 6-to 7-month period during which the children or their parents infused IVIg in a home setting. Eight children received an average dose of 204 ± 12 mg/kg every 2 weeks, two children received a dose of 400 mg/kg every month, and an additional two children received 240 to 250 mg/kg every 10 days. Peak and trough levels varied from 946 ± 20 mg/dL and 627 ± 16 mg/dL, respectively, in children receiving IVIg every 2 weeks. The peak-trough values for the children receiving IVIg every month were 1105 ± 94 mg/dL and 457 ± 78 mg/dL, while those of children receiving IVIg every 10 days were 840 ± 24 mg/dL and 553 ± 109 mg/dL. A total of 224 infusions were administered, with only two minor reactions occurring (reaction rate of 0.9%). There was no difference in the frequency of infections and antibiotic use during the study compared with the previous phase. The results demonstrate that home self-infusion of IVIg in children is safe and feasible.