Explore how Hizentra® PFS can simplify the infusion process for patients and caregivers.
By Candy Finley, RN, IgCN, Clinical Nurse Educator II - April 28, 2025
Hizentra® is indicated for Primary immunodeficiency (PI) in adults and pediatric patients 2 years of age and older and maintenance therapy in adults with chronic inflammatory demyelinating polyneuropathy (CIDP). Upon initial FDA approval, Hizentra® was commercially available in vials only. The manufacturer of Hizentra®, CSL Behring, has since transitioned from vials to prefilled syringes (PFS). Hizentra® is available in 1 gm/5 mL, 2 gm/10 mL, 4 gm/20 mL, and 10 gm/50 mL sizes. The recommended Hizentra® dose and volume, rate per SC site and volume per SC site are typically greater in CIDP compared to PI (consult the package insert for details Hizentra Package Insert).
KORU™ Medical Systems makes two mechanical syringe pumps, the Freedom60® Infusion System and the FreedomEDGE® Infusion System. The Freedom60® uses a 50 mL BD® syringe or 60 mL Medline syringe to deliver medications and is FDA-approved for the use with the Hizentra® 10 gm/50 mL PFS. The FreedomEDGE® uses a 20 mL or 30 mL BD® syringe to deliver medications and is FDA-approved for the use with the Hizentra® 4 gm/20 mL PFS. Depending on the Hizentra® dose, some patients may be able to directly insert a Hizentra® PFS into the syringe pump or they need to transfer Hizentra® to an appropriate size commercial syringe compatible with the pump before infusing. I hope this blog makes it easier to understand the best practice for use.
Benefits of PFS include:
- Ease of Use: PFS are typically ready for immediate use, reducing the need to draw up the SCIG from vials, which may avoid waste of product caused by accidently dropping a vial or inadvertently pulling out the plunger. For those with dexterity problems, PFS may be easier to manipulate than vials.
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Time Efficiency: By eliminating the need for drawing up medication from vials, patients decrease the time on that process, making it less time consuming.
- Portability: The compact design enhances portability and saves space too, making it easy to infuse on the go.
Administration Guidelines:
Proper administration is vital to ensure the safety and effectiveness of Hizentra®. Appropriate sites include the abdomen and upper mid- to outer thighs. If the patient has a caregiver to assist with administration, additional sites include the back of the upper arm and side of the upper hip (flank). Trials of different sites should be encouraged as part of the effort to find the ideal individual regimen. Rotating sites or not is acceptable and based on tolerance and patient preference.
Hizentra® 10 gm/50 mL PFS are more slender than the BD® 50 mL syringe which may result in a slightly longer infusion time. The Freedom60® Syringe Adapter must be used with the Freedom60® and the Hizentra® PFS. Only use infusion pumps FDA-approved for use with Hizentra® PFS like the Freedom60® and FreedomEDGE® pumps to ensure controlled delivery rates.
Freedom60 Syringe Adapter Instructions for Use
Freedom60 Syringe Adapter Video
If the PFS is not compatible with the pump, the contents must be transferred into a compatible empty commercial syringe. Syringe to syringe transfer requires the use of a transfer device (e.g., a fluid dispensing connector).
To watch an instructional video on syringe to syringe transfer go to https://korumedical.com/instruction-videos/ and click on syringe to syringe drug transfer video.
- The difference in time of delivery between the PFS vs. a commercial syringe will be more evident with larger doses.
Patient Experiences
Some patients have reported positive experiences with Hizentra® PFS. The convenience with the ready to use system has led to increased satisfaction among those with dexterity or strength challenges. This provides them with a greater ability to be compliant with their therapy, making it seem like less of a chore.
In Conclusion
The introduction of Hizentra® PFS for the treatment of patients with immunodeficiency and other disorders has simplified the infusion process for patients and caregivers. The more convenient method may promote compliance and contribute to better health outcomes.
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