Real-World Use of Recombinant Human Hyaluronidase-Facilitated Subcutaneous Infusion of Immunoglobulin G (IG) (IGHy) in Patients with Primary Immunodeficiency Disorders (PIDD)
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Kevin P. Rosenbach, MD, FAAAAI, Stephanie Hughes, PharmD, Leon Rozen, MBBS
Rationale: IGHy (HYQVIA) was approved September 2014 in the US for the treatment of PIDD in adults. Data from a single-practice cohort was analyzed to understand IGHy treatment adoption.

Methods: A chart review of patients in a private practice who initiated treatment with IGHy, or switched from intravenous IG (IGIV) or conventional subcutaneous IG (IGSC) to IGHy, was performed.

Results: Between October 2014 and July 2015, 19 patients (aged 32-74 years; 68% female) began IGHy. IG replacement therapy before switching to IGHy included IGIV (n=2), IGSC (n=15), or none (n=2). Reasons for switching from IGIV were poor venous access (n=1) and desire to self-infuse (n=1). Reasons for switching from IGSC included desire for less frequent infusions (n=11), less needle sticks (n=2), systemic adverse reactions (ARs) (n=1), and non-adherence (n=1). Five patients, all of whom were among the first 9 treated with IGHy, switched back to IGIV (n=1; poor onboarding experience with training) or IGSC (n=4: local ARs [n=3]; preference for lower weekly IGSC volume [n=1]). Three of 4 patients who experienced IGHy as their first subcutaneously-administered IG currently remain on treatment. As the multidisciplinary care team gained expertise with IGHy, patient experience improved and patients opted to continue IGHy treatment. Care team key learnings included providing details on post-infusion site appearance, choosing proper needle length, and the option of adding a second infusion site.

Conclusions: In this real-world cohort, as the multidisciplinary care team gained experience with IGHy, patient retention improved. These data highlight the importance of an individualized patient infusion experience with IGHy.