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This is a combination therapy involving both intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG). Both are purified preparations of human immunoglobulin G (IgG) derived from pooled plasma of healthy donors. They are used as replacement therapy in patients with primary or secondary antibody deficiencies and for certain autoimmune or inflammatory disorders. IVIG is administered via the intravenous route, typically every 3–4 weeks, resulting in higher peak but lower trough serum IgG levels; it is associated with more systemic adverse effects. SCIG is administered more frequently (weekly or biweekly), usually at home by the patient or caregiver, leading to steadier serum IgG concentrations and fewer systemic side effects but more local site reactions. The mechanism of action includes direct replacement of missing antibodies for infection prevention as well as complex immunomodulatory effects on cytokines, complement pathways, Fc receptors, B cells, T cells, dendritic cells, and autoantibodies[1][5][6]. This combination may be used sequentially during transitions between routes or concurrently in select clinical scenarios.
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