UKPIN Position Statement
Immunoglobulin Product Choice for Patients with Primary Immunodeficiency
UKPIN seeks to ensure the highest quality of service and support for patients with primary immunodeficiencies. In pursuit of this:
1. Patients with primary antibody deficiency should be offered treatment with either intravenous or subcutaneous immunoglobulin.
2. UK PIN recognises that patients with primary antibody deficiencies require life-long therapy that is acceptable and tolerable, and that the issues of immunoglobulin product choice therefore differ from other immunoglobulin uses.
3. Patients should be given the option of undertaking treatment with immunoglobulin replacement therapy in a specialist centre, at their local hospital or at home if appropriate. This should be based on patient need and not on cost.
4. Patients may be intolerant of a particular product. Product choice is therefore critical for the patient and their treating clinician in order to ensure appropriate and safe therapy.
5. Patients already established on a particular product must not have their product changed for non-clinical reasons and patients being treated outside of recognised PID Centres must not have changes in product without this being discussed with the treating Immunologist. This is recognised by other international guidelines.
6. UKPIN recognises that there may be fluctuations in the supply of particular products and endorses, as best practice, maintenance of a diversity of available immunoglobulin preparations in order to minimise disruption in the event of withdrawal or interruption of supply of a particular product.
7. Patients with primary antibody deficiencies should have as wide a choice as possible of intra-venous and subcutaneous immunoglobulins available for long term use. The availability of a minimum of 4 different intravenous immunoglobulin and subcutaneous (preferably equivalent) products is recommended.
8. Although UK PIN recognises the need for cost-effective drug administration, and endorses the Guidelines on Immunoglobulin use issued by the Department of Health, safety of immunoglobulin products must be of paramount importance.