Subcutaneous “bolus” immunoglobulin dose in CIDP: A proof-of concept study

Abstract Background Subcutaneous (SC) immunoglobulin (Ig) is an effective therapy for Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP). However, optimal dosage and frequency of administration remain to be clarified. Objectives We sought to assess the feasibility and tolerability of a novel regimen of SCIg administration, based on concentrated “bolus” doses delivered every other week, as compared to the “conventional” SCIg regimen, based on 1–3 administrations/week. Materials and methods Consecutively consenting CIDP patients (6 men and 1 woman) were crossed-over from SCIg “conventional” to SCIg “bolus” and followed-up for 6 months. The main endpoints were: tolerability, defined as the percentage of patients successfully completing the study, patient's perceived disability, as measured by the Rasch-built Overall Disability Scale (R-ODS), life quality index (LQI), and inflammatory neuropathy cause and treatment (INCAT) scale. Results SCIg “bolus” was well tolerated by all patients. The R-ODS score significantly improved (p = 0.042), as well as the LQI sub-domains related to the interference of treatment in daily living activities (p = 0.026), and therapy-related problems (p = 0.039). No significant change was observed in the INCAT (p = 0.317) score. There were no cases of drop-out and/or dose adjustment during follow-up. Conclusions SCIg “bolus” seems to represent an effective and well-tolerated option for CIDP maintenance therapy.