What is subcutaneous immunoglobulin?

Your doctor has prescribed you immunoglobulin replacement or immunomodulation therapy. This means delivering immunoglobulins, also known as antibodies, into your body. This can be done either intravenously (into a vein - IVIg) or subcutaneously (into the fatty tissue that lies between the skin and muscle - SCIg).

Why would I consider SCIg?

SCIg is very safe. We can show you how to give yourself the therapy at home. The choice between IVIg and SCIg depends on several things which should be discussed with your treating doctor.

The difference between SCIg and IVIg

SCIg

• You can do it at home. Training will be provided.
• You give yourself the infusion into the fatty tissue under the skin.
• Can be used for patients who have frequent bad reactions to IVIg
• Can be done at a time that fits your routine. Fewer hospital visits, less burden on you to travel to the hospital. You must follow the treatment plan and document therapy.
• Each infusion takes 1-2 hours. Once or twice per week, as prescribed by your doctor.
• The level of immunoglobulin will be more stable over time, resulting in less side effects. Side effects: swelling, redness and itching at the place you inject can last 1-2 days.
• You can take SCIg with you when travelling.

IVIg

• In Australia IVIg is done in hospital. It is given by a nurse.
• You must attend hospital every month or as recommended by your doctor. Arranged by the hospital when times are available.
• Each infusion takes 2-5hours. 1 per month (every 4 weeks) or as required by your doctor.
• Rapid rise in immunoglobulin levels can cause side effects that last for up to 2 weeks after infusion, including headache and flulike symptoms. You may get a “wear off” effect of reduced immunity, up to a week or so before your next infusion, as immunoglobulin levels drop. For example, fatigue.
• Can be difficult to arrange treatment when travelling, especially overseas.

How do I start SCIg?

Your treating doctor will help you decide if SCIg or IVIg is best for you based on your needs. They will also regularly review how well it is working for you.

The SCIg nurse is available to show you how to do the treatment yourself and help you to get the products you need to keep doing the treatment at home. Patients in Australia, including those living regionally, can access SCIg through government funding. There are support services such as a drive-through collection service at Canberra Hospital. Regional patients can access SCIg from their local Hospital. The SCIg nurses are also able to give you information about other support services.

If you have any questions about your treatment or SCIg, please discuss them with your doctor.

Switching to SCIg and administering at home from a patient’s perspective.

“Hi there. My name’s Patsy* and, like you, I need regular doses of immunoglobulin to keep me well.

I started IVIg 11 years ago at the Canberra Hospital where I needed to attend for half a day every month. It could be a bit inconvenient having to book a month in advance because often situations would crop up and you wouldn’t want to cancel your booking or inconvenience the other-patients or staff.

After about 4 years of this treatment, it was suggested to me that I might like to transfer to the SCIg program. I was interested but nervous. I had no medical background and had never given myself a needle. I thought I would give it a go and quite honestly it was one of the best decisions I have made. In fact, I would say it changed my lifestyle.

I was booked into the hospital for two 2-hour training sessions. In the two training sessions, I was taught everything I should know from how to set up and sterilise the work area, how to administer the treatment and what to do when it’s finished. I could have had another session, but I felt I would be able to manage. I never looked back!

The advantages I gained from taking control of my own treatment included:

• Choosing when to do my treatment. No more having to book a month in advance. It also made travel much easier.
• During my SCIg infusion, I could walk around, answer the phone, read the paper, talk to my husband, listen to the radio and enjoy my breakfast! I didn’t have to worry about driving to the hospital and finding a place to park! (My blood pressure was often elevated after finally finding a park!)
• The SCIg infusion would be finished in 40 minutes! All done for a week with minimal disruption to my life.

I can’t recommend SCIg highly enough. You finally have control over your own treatment with as little disruption to your life as is possible.”

* Patsy is a genuine patient of the Canberra Hospital Immunology Department. Any views expressed are solely her own.

Where do I find more information?

Speak to your doctor to find out if SCIg is for you. For more information about SCIg, contact your doctor or the SCIg nurse on TCHSCIG@act.gov.au