Subcutaneous administration is a route of administering medication to non-Hodgkin lymphoma (NHL) patients. NHL is a type of cancer that affects the lymphatic system. It is the fifth most commonly diagnosed cancer in the United States.

The treatment of NHL typically involves chemotherapy, radiation, and immunotherapy, among others. Subcutaneous administration is a relatively new mode of administering medication to NHL patients.

What is subcutaneous administration?

Subcutaneous administration involves injecting medication into the layer of skin below the dermis and epidermis. The medication is absorbed into the bloodstream from the subcutaneous fatty tissue.

This mode of administration is ideal for medications that are not suited for oral administration or intravenous injection. Subcutaneous administration is preferred over intravenous injection as it can be done outside of the hospital, reduces the risk of infection, and does not require skilled personnel.

Why is subcutaneous administration recommended for NHL patients?

Subcutaneous administration is recommended for NHL patients due to a variety of reasons.

Firstly, subcutaneous administration reduces the frequency of administration, as compared to oral and intravenous routes, leading to a reduced number hospital visits. Secondly, subcutaneous administration overcomes the first-pass effect, rendering the medication more effective.

Lastly, subcutaneous administration reduces the risk of infection that occurs due to repeated intravenous injection, and can also lead to an improvement of quality of life.

What medications are administered subcutaneously to NHL patients?

Several medications can be administered subcutaneously to NHL patients. Rituximab, a monoclonal antibody that targets the CD20 protein found on B-cells, is commonly administered subcutaneously.

Other medications administered subcutaneously to NHL patients include epoetin alfa, which stimulates the production of red blood cells, granulocyte colony-stimulating factor, which stimulates the production of white blood cells, and trastuzumab emtansine, a targeted medication used for the treatment of HER2-positive NHL.

Authorization of subcutaneous administration for NHL patients

In the United States, the Food and Drug Administration (FDA) has authorized subcutaneous administration of rituximab for NHL patients.

The FDA approved subcutaneous administration of rituximab in 2017, following clinical trials that demonstrated the efficacy and safety of subcutaneous administration. Subsequently, other medications, like trastuzumab emtansine, have also been authorized for subcutaneous administration.

Clinical studies comparing subcutaneous administration with intravenous administration of medications for NHL patients

Clinical studies have shown that subcutaneous administration is as effective as intravenous administration of medications for NHL patients.

A randomized controlled trial comparing subcutaneous administration with intravenous administration of rituximab showed that subcutaneous administration was non-inferior to intravenous administration in terms of efficacy and safety.

Another clinical study compared subcutaneous administration of trastuzumab emtansine with intravenous administration in patients with HER2-positive NHL and showed similar efficacy and safety profiles, while reducing the duration of administration and improving quality of life.

Factors to consider while administration of medications subcutaneously

While subcutaneous administration is a preferred mode of administering medication to NHL patients, certain factors must be considered while administering medications subcutaneously.

These include proper training, sterile administration to avoid infections, and administration according to the guidelines set by the manufacturer of the medication. It is also crucial to monitor the patient closely while administering the medication subcutaneously to manage any side effects and ensure proper absorption of the medication.

Conclusion

Subcutaneous administration is a preferred mode of administering medication to NHL patients. It reduces the frequency of administration, overcomes the first-pass effect, and reduces the risk of infection that occurs with repeated intravenous injection.

The FDA has authorized subcutaneous administration of rituximab, and clinical studies have demonstrated its efficacy and safety. However, proper training, sterile administration, and adherence to manufacturer guidelines are necessary while administering medications subcutaneously to NHL patients.