Replacement IgG Therapy and Self-therapy At Home Improve the Health-related Quality of Life in Patients with Primary Antibody Deficiencies

Ann Gardulf; Uwe Nicolay

Disclosures

Curr Opin Allergy Clin Immunol. 2006;6(6):434-442. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: This article describes the health-related quality of life and health of patients suffering from primary antibody deficiencies before and after the initiation of lifelong IgG replacement therapy, and before and after the introduction of home-therapy regime programmes. The importance of including patient-reported or parent-reported outcomes in evaluations of treatment and care of this group of patients is also discussed.
Recent Findings: Recently diagnosed adults suffering from primary antibody deficiencies and not yet on IgG therapy report poor health and poor health-related quality of life as compared with healthy individuals. Weekly subcutaneous IgG infusions (100 mg/kg) significantly improve health and normalize health-related quality of life. IgG self-infusions at home further improve the self-reported health and health-related quality of life of both adults and children. Being able to self-infuse at home instead of visiting the hospital two to four times per month has been shown to increase the treatment satisfaction of both adult patients and their families, and to result in increased flexibility, independence and sense of self-control.
Summary: Adequate IgG replacement therapy means a dramatically improved life situation. Home-therapy programmes should be encouraged, as self-infusions at home further improve health-related quality of life and self-perceived health.

Introduction

The first article ever to describe the health-related quality of life (HRQL) in patients suffering from primary antibody deficiencies (henceforth called PADs) and including the patients' subjective evaluation of their health, wellbeing, ability to perform daily activities, and physical, social, and emotional functioning was published in 1993,[1] more than 40 years after the first report[2] describing primary immunodeficiencies and replacement therapy with immunoglobulin G (IgG) in humans. HRQL is a very important measure of the patients' and families' subjective health-status assessment which may be affected by healthcare interventions, wellbeing and life situation. Patients' satisfaction with the medicinal and nonmedicinal aspects of their medication, including interpersonal aspects and processes of treatment, impacts their decision-making and thus ultimately their compliance with the treatment.[3,4,5] HRQL is also an important outcome measure in health-economic evaluations[4] and is increasingly recognized by the pharmaceutical research community as an outcome endpoint during drug development.[6,7,8]

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