To assess dosing of IgPro20 (immune globulin subcutaneous [human], 20% liquid, Hizentra®) in clinical practice in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Subcutaneous immunoglobulin (SCIg) approved for maintenance therapy for CIDP, enables consistent Ig levels and improved quality of life compared with intravenous immunoglobulin (IVIg). Optimal treatment uses the lowest effective dose tailored to patient needs; however, limited data on the clinical practicalities of individualizing SCIg are available. 

This is a retrospective, non-interventional, study of 20 patients with CIDP who were initially treated with IVIg then transitioned to maintenance SCIg (IgPro20, CSL Behring). Data were obtained from patient medical records from eight US centers.

The approved dose for SCIg in CIDP is 0.2 or 0.4g/kg/week. Of patients with available IVIg data (n=19), 8 (40%) transitioned on a 1:1 IVIg:SCIg ratio (0.13–0.50g/kg/week SCIg). The remaining patients transitioned to lower (n=8) or higher (n=3) SCIg doses relative to prior IVIg.

Nine patients (45.0%) did not require any dose adjustments, while six (30.0%) patients had their IgPro20 dose increased at least once to maintain clinical stability. A further four patients (20%) underwent dose reductions, two of whom successfully maintained stable disease at lower doses, while two patients demonstrated signs of relapse and were returned to higher doses for disease stabilization; one returned to their baseline dose, and one underwent a series of dose adjustments and was eventually maintained on a dose slightly higher than baseline.

These cases demonstrate the flexibility of SCIg treatment in patients with CIDP, highlighting the importance of close follow-up to individualize SCIg therapy and achieve optimal clinical outcomes.