What is infusion therapy? Infusion therapy involves the administration of medication through a needle or catheter. Typically, infusion therapy means that a drug is given intravenously IV in a catheter that is in your vein, but the term also may refer to situations where drug is being administered subcutaneously under the skin. Why do I need infusion therapy?
Some people have a disease that may need intermittent or long-term treatment. Infusion therapy can enhance your overall health and can provide you with treatment that can be life-sustaining. What medications might be given with infusion therapy? Many different preparations of IVIG are available from different companies. You should work with your doctor to identify which product will work best for you. Many patients can receive immunoglobulin replacement in other ways, such as subcutaneously under the skin, instead of in the vein.
Some patients begin with IVIG therapy and switch to other methods so that they can administer immunoglobulin at their convenience at home. If you are interested in such options, you should talk to your doctor. Many other medications, such as antibiotics, steroids, and IV fluids, can be given intravenously.
How are immunoglobulin preparations made? Rashes can be treated with hydrocortisone cream, calamine lotion, antihistamines, and cold compresses.
Talk to your doctor or nurse for more specific treatments. The immune globulin product is delivered through a:. An infusion pump is programmed to deliver the IVIg at a predetermined rate to ensure the body does not experience any adverse reactions. Pre-medications are often taken to minimize or prevent side effects, including headaches, fatigue, and allergic reactions. Learn More. Typically, IVIG treatments will be administered every 3 to 4 weeks.
Being fully hydrated before your IVIG infusion can help minimize symptoms like headaches after the treatment. Although most recipients of IVIG handle the treatment quite well, some people do experience side effects.
Some may also experience an allergic reaction , typically caused by the added stabilizers and other inactive ingredients in the IVIG formula. Premedications such as Aspirin and Benadryl are often administered before the procedure to address these known side effects. Additionally, administering the immune globulin at a slower rate may help prevent or lessen the severity of these side effects.
Experienced infusion centers and nurses will often take precautions to prevent or help minimize any side effects before beginning treatment. At Ameripharma, we have experienced and caring nurses that work hard to ensure your comfort and safety. If you experience any of the side effects listed above, you may be given medications to alleviate the symptoms after your treatment session:.
Ig is created from the extracted antibodies of thousands of blood donors, and each manufacturer produces the end product with its own unique blend of stabilizers and liquids. Because of these variables, your body may react differently during each infusion session. It is important to log the side effects or lack of that you experience after each infusion so that your doctor can adjust your regimen.
Although acknowledged, accounts of wear-off effect are largely anecdotal, with few studies on this subject having been conducted to date. The aim of this investigation was to quantify the objective and subjective signs and symptoms of wear-off effect towards the end of the treatment cycle. These multicenter trials were conducted in the United States and Canada from September to January Data from patients with data points were used for the infection analysis, and data from patients with 23, data points for the analysis of overall well-being.
All patients participating in the studies analysed here provided written informed consent. Approval from institutional review boards was obtained prior to the start of the studies.
All endpoints and methods of their evaluation in the original studies were prespecified in the respective study protocols. The results reported here are from a post hoc retrospective pooled analysis of raw patient data.
The number of days hospitalized was assessed as the number of days hospitalized due to the underlying PID. All patient data collected from Day 1 of the study until 48—96 h after the last infusion of the study, were used in the analyses. Patients were advised that a missing entry in the diary would be interpreted as no event. If the diary was not provided, the data were to be considered missing, but such case was not recorded for any of the diary data endpoints.
Of these patients, 33 were on a 3-week cycle and 86 on a 4-week cycle, representing a total number of and dosing cycles, respectively. Patients recorded daily their perception of overall well-being on a scale of 1—5, in which a score of 1 equated to very poor; 2, poor; 3, fair; 4, well; and a score of 5, very well.
The clinical studies analyzed in this study were completed before the FDA guidance on patient-reported outcomes development [ 14 ] was published. To determine what could be considered a meaningful change in well-being score, a data variance analysis was performed. Objective wear-off endpoints were analyzed by treatment cycle week using a generalized linear model for repeated count data within unique patients and compound symmetry correlation structure without any covariates.
The actual time between infusions was accounted for in the model. Distribution analysis was performed using quasi-likelihood under the independence model criterion QIC [ 15 ]. The corresponding risk ratios vs. Week 1 were calculated. Analyses for the probabilities of infection, days off and hospitalization were additionally performed with time intervals shifted by 3 days Week 1 covers Days 3—9; Week 2 covers Days 10—16; Week 3 covers Days 17—23; and Week 4 covers Days 24—31 based on the hypothesis that the average incubation period of the most common respiratory infections is approximately 3 days [ 16 ].
Overall well-being scores were analyzed using descriptive statistics. No imputation was performed for missing data for overall well-being. A total of 8 out of 23, data points 0. The influence of these missing data points was considered extremely low and thus excluded from analysis.
No adjustment of p -values for multiplicity was done in this post hoc analysis. The majority of patients in each of the three studies was diagnosed as having CVID, and on average the duration of PID before study entry was 8—11 years.
The median number of dosing cycles recorded in the study was 7 range: 1—38 for the 3-week cycle, and 6 range: 1—31 for the 4-week cycle. The median number of dosing cycles for the set of patients for which overall well-being scores were assessed, was 8 range: 3—15 for the 3-week cycle, and 8 range: 1—12 for the 4-week cycle. The most common infections experienced by patients were sinusitis, nasopharyngitis and upper respiratory tract infections. The probability of a first infection during a dosing cycle was significantly increased in the last week of the 4-week dosing cycle.
There was also an increased probability of a first infection in the last week of the 3-week dosing cycle, although this did not reach statistical significance Fig. Compared with Week 1, the risk ratio for a first infection during the final cycle week was 1. However, these factors had only a minimal impact on the risk ratio for infection in the final week compared with Week 1.
Probability of first infection per week within the dosing cycle. The probability of a first infection at each week of a 3-week a , or 4-week b dosing cycle was determined by binomial distribution: c Risk ratio of a first infection during Week 1 of the dosing cycle compared with subsequent weeks. The probability of days with infection was significantly lower in the second and third weeks of the 3- and 4- week dosing cycles, respectively Fig. Shifted time interval analysis accounting for the average incubation period of infection showed that the probability of infection was greatest during the last week of the cycle for both 3- and 4- week cycles, with a significantly greater risk compared with Week 1 1.
Probability of days with infection per week within the dosing cycle. The probability of days with infection, as determined by negative binomial distribution, is shown for each week of the 3-week a and d and 4-week b and e dosing cycles using non shifted a and b or shifted d and e time intervals; risk ratio of a day with infection during Week 1 of the dosing cycle compared with subsequent weeks using non shifted c and shifted f time intervals.
Time intervals were shifted by 3 days to account for infection incubation period: Week 1 covers Days 3—9; Week 2 covers Days 10—16; Week 3 covers Days 17—23; and Week 4 covers Days 24— The probability of fatigue was greatest in the first week of both the 3- and 4-week dosing cycles, and was significantly lower in the subsequent weeks of the treatment cycle Fig. Compared with Week 1, the risk ratio for fatigue in subsequent weeks was at most 0.
Probability of fatigue.
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