Safety of intravenous immune globulin in an outpatient setting for patients with neuromuscular disease

Muscle Nerve. 2019 Nov;60(5):528-537. doi: 10.1002/mus.26678. Epub 2019 Sep 6.

Abstract

Introduction: Although intravenous immune globulin (IVIg) is used to treat patients in the outpatient setting, there is limited documentation addressing the safety of this practice.

Methods: Retrospective analysis of 438 patients with neuromuscular diseases receiving IVIg in an outpatient setting.

Results: Adverse events (AE) overall occurred in 16.9% of patients. Headache was the most common AE, noted in 11.6% of patients. Serious AEs occurred in 0.91% of patients; aseptic meningitis was the only one noted. Multivariate analyses identified the following risk factors for AEs: first-lifetime course of IVIg, higher dose per course of IVIg, diagnosis of myasthenia gravis, women, and younger age.

Discussion: Intravenous immune globulin is generally safe to administer in an outpatient setting. Women, myasthenia gravis patients, and those receiving their first course or a higher total dose of IVIg are at an increased risk of experiencing an AE.

Keywords: adverse event; complications; intravenous immune globulin; myasthenia gravis; neuromuscular disease; outpatient infusion.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Ambulatory Care
  • Exanthema / chemically induced
  • Female
  • Headache / chemically induced
  • Humans
  • Hypertension / chemically induced
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors / therapeutic use*
  • Infusions, Intravenous
  • Male
  • Meningitis, Aseptic / chemically induced
  • Middle Aged
  • Multivariate Analysis
  • Myasthenia Gravis / therapy
  • Myositis / therapy
  • Neuromuscular Diseases / therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy
  • Retrospective Studies
  • Risk Factors
  • Sex Factors

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors