Researchers conducted a study into the barriers that patients with alpha-1 antitrypsin deficiency (AATD) encounter when self-administering augmentation therapy during the COVID-19 pandemic, as published in Pulmonary Therapy

Alpha-1 antitrypsin (AAT) augmentation therapy is typically infused once weekly in patients with AATD to raise serum AAT levels to a therapeutic threshold. Studies indicate that this therapy poses a significant burden on patients as the treatment is both expensive and disruptive to their daily lives.

The COVID-19 pandemic has normalized the self-administration of augmentation therapy. This allows patients with AATD to minimize their risks of exposure to COVID-19 and reduces their need to travel. Colello and colleagues hence decided to investigate patient reluctance to self-administer augmentation therapy during the pandemic.

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“In this protocol, we did not alter therapy in any way, but instead assessed why patients may or may not be open to converting to self-augmentation, focusing on the pandemic,” Colello et al wrote.

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The research team conducted a phone questionnaire with 22 patients with severe AATD who were actively receiving augmentation therapy. They discovered that the average length of intravenous augmentation therapy was 9.5 years. Sixteen out of the 22 patients were aware that self-infusion was an available option, and 8 expressed a willingness to transition to self-infusion if education and training were provided.

The results demonstrated that the most common reasons for refusing to self-infuse augmentation therapy were “fear of consequence if improperly injected,” “lack of skills (dexterity required for self-administration),” and “worry about financial restraints.”

In addition, 4 patients reported having above-normal anxiety, and 6 reported experiencing depression. However, none of these factors were associated with patient willingness to consider self-infusion therapy.

“This study has both solidified current understandings of patient perceptions regarding [AAT] infusion options and brought to light additional considerations for the future, even in the face of a pandemic,” Colello and colleagues concluded.


Colello J, Ptasinski A, Zhan X, et al. Assessment of patient perspectives and barriers to self-infusion of augmentation therapy for alpha-1 antitrypsin deficiency during the COVID-19 pandemicPulm Ther. Published online January 24, 2022. doi:10.1007/s41030-022-00182-z