Background/Purpose: Intravenous Immunoglobulin (IVIg) is used to treat rheumatic conditions such as Inflammatory Myositis. Subcutaneous Immunoglobulin (SCIg) is an alternative route of administering Immunoglobulin. Studies have demonstrated that home-based SCIg therapies are cost-effective with similar outcomes and less adverse events compared to IVIg. To date, there have been no studies that have investigated patient satisfaction with respect to IVIg use in myositis. Our objective was to characterize patient satisfaction regarding IVIg in the treatment of their myositis, and to explore their perceptions of SCIg and interest in transitioning to SCIg.

Methods: Adult patients (age 18+) receiving IVIg for Inflammatory Myositis at a Tertiary Centre in Ottawa, Canada were approached and provided informed consent to participate. An adaptation of the validated Treatment Satisfaction Questionnaire for Medication (TSQM) was administered to collect data on patient satisfaction of IVIg across 4 domains (effectiveness, convenience, side effect burden, and global satisfaction) and to gauge interest in SCIg. Data was collected using a 5 or 7-point Likert scale. Results were anonymized and summarized descriptively with means reported. Ethics approval was obtained from the Ottawa Health Science Network Research Ethics Board.

Results: Indications for IVIg included Dermatomyositis (50%), Polymyositis (12.5%), Anti-Synthetase Syndrome (12.5%), and other Inflammatory Myositis (25%). 50% of participants had received IVIg for more than 3 years, 37.5% had received for less than 1 year, and 12.5% had received for 1-3 years. On average, participants were satisfied with the effectiveness of IVIg (5.6/7). Participants were somewhat dissatisfied with the convenience (4.7/7) but satisfied with the ease of planning when treatments occur (5.6/7). 87.5% of participants had experienced side effects including headache (75%), fatigue (37.5%), nausea (25%), chills (25%), and cramps (12.5%). Side effects were rated as somewhat bothersome. Overall, participants were somewhat dissatisfied with their experience of IVIg (4.9/7). Scores across all 4 domains were similar regardless of diagnosis or treatment duration. 87.5% of participants had not heard about SCIg previously. Participants were somewhat uncomfortable with the idea of SCIg (4/7) with 37.5% citing lack of knowledge. 37.5% were willing to switch to SCIg, 12.5% were not, and 50% were unsure. Those willing to switch to SCIg had on average received IVIg for a shorter duration.

Conclusion: Our results suggest that participants are satisfied with the effectiveness of IVIg in treating their myositis but somewhat dissatisfied with the convenience. This discrepancy has been previously reported in other diseases treated with IVIg, with the inconvenience being attributed to the frequency and duration of infusion appointments. We hypothesize that inconvenience, in addition to somewhat bothersome side effects, may be driving down the global satisfaction score in our study. SCIg may offer a solution to the inconvenience of IVIg, though unfamiliarity with SCIg may be a barrier to patient buy-in. Further patient education on SCIg as a treatment option in Inflammatory Myositis is required.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-survey-of-treatment-satisfaction-with-intravenous-immunoglobulin-among-patients-with-inflammatory-myositis/