“I have regained control of my life”. This verbatim summarises the very consensual view of a group of seven adults with polymyositis or dermatomyositis on the home administration of polyvalent immunoglobulins (Ig) subcutaneously, using an infusion pump or syringe pump. Followed at the Pitié-Salpêtrière Hospital (Paris), these patients took part in a qualitative study, which published its results in February 2020:
- they all preferred subcutaneous (SC) administration of Ig at home rather than intravenous (IV) administration in hospital;
- the SC route increases the feeling of autonomy and control, with six patients self-administering their Ig treatment and being able to choose the time of injection;
- All patients consider this treatment method to be easier, less disruptive to their daily activities and less time-consuming, advantages that counterbalance the need for more frequent SC injections than IV;
- Most consider the SC route to be effective and well tolerated.
A second retrospective study confirms these French results. Conducted in Canada, it is based on data from 20 patients suffering from various types of myositis (dermatomyositis, autoimmune necrotising myopathy, antisynthetase syndrome, etc.), treated for at least a year with SC Ig, after having been treated with IV Ig:
- this switch was not accompanied by a significant increase in disease activity (MITAX score) or in the cumulative annual dose of corticosteroids;
- five patients had to increase the dose of their immunosuppressive treatment, but four benefited from a reduction in this treatment;
- 78.9% of participants said they preferred the SC route to the IV route, and 83.3% preferred home treatment to hospital treatment.
