Literature DB >> 20204337

Use of non-specific intravenous human immunoglobulins in Spanish hospitals; need for a hospital protocol.

Belen Ruiz-Antorán1, Antònia Agustí Escasany, Antoni Vallano Ferraz, Imma Danés Carreras, Neus Riba, Silvia Mateu Escudero, Joan Costa, M Blanca Sánchez Santiago, Leonor Laredo, José Antonio Durán Quintana, Juan Ramón Castillo, Francisco Abad-Santos, Concepción Payares Herrera, Belén Sádaba Díaz de Rada, Eugenio Gómez Ontañón.   

Abstract

UNLABELLED: Intravenous immunoglobulin (IVIG) use in non-approved indications, the increase in consumption and its high cost recommend rationalisation in its utilisation. AIMS: To assess the use of IVIG in Spanish hospitals.
METHODS: An observational, prospective and multicentre drug utilisation study was conducted in 13 tertiary Spanish hospitals. Data were collected for 3 months in patients receiving any IVIG. Patient demographics, indication for IVIG use, dosage regimen and cost of treatment were collected.
RESULTS: Five hundred and fifty-four patients (mean age of 52 years) were included in the study. A total of 1,287 prescriptions were administered, and the average number of prescriptions per patient was 2.3. The mean daily dose was 24 g (range 0.6-90 g). Overall, IVIG was prescribed for authorised indications in 335 patients (60%) with 953 prescriptions (74%), for non-authorised indications with scientific evidentiary support in 86 patients (16%) with 137 prescriptions (11%), and non-authorised and non-accepted indications in 133 patients (24%) with 197 prescriptions (15%). The most frequent authorised indications were primary and secondary immunodeficiencies, and the most frequent non-authorised and non-accepted indications were multiple sclerosis and bullous dermatosis. The mean cost of IVIG per patient for authorised indications was 2,636.2 <euro>, non-authorised indications with scientific support 5,262.1 <euro> and non-accepted indications 3,555.8 <euro>.
CONCLUSIONS: IVIG is prescribed for a significant number of non-authorised and non-accepted indications with a notable cost. There is an important variability in IVIG prescriptions between hospitals, indicating room for improvement in IVIG use and the need for a consensus of protocol use.

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Year:  2010        PMID: 20204337     DOI: 10.1007/s00228-010-0800-y

Source DB:  PubMed          Journal:  Eur J Clin Pharmacol        ISSN: 0031-6970            Impact factor:   2.953


  27 in total

Review 1.  Intravenous immunoglobulin: regulatory perspectives on use and supply.

Authors:  A Farrugia; P Poulis
Journal:  Transfus Med       Date:  2001-04       Impact factor: 2.019

2.  A multicenter drug use surveillance of intravenous immunoglobulin utilization in US academic health centers.

Authors:  C Chen; L H Danekas; T A Ratko; P H Vlasses; K A Matuszewski
Journal:  Ann Pharmacother       Date:  2000-03       Impact factor: 3.154

Review 3.  Use of intravenous immunoglobulin for treatment of neurologic conditions: a systematic review.

Authors:  Dean Fergusson; Brian Hutton; Michael Sharma; Alan Tinmouth; Kumanan Wilson; D William Cameron; Paul C Hebert
Journal:  Transfusion       Date:  2005-10       Impact factor: 3.157

Review 4.  IGIV in neurology--evidence and recommendations.

Authors:  V Bril; K Allenby; G Midroni; P W O'Connor; J Vajsar
Journal:  Can J Neurol Sci       Date:  1999-05       Impact factor: 2.104

5.  High dose intravenous immunoglobulin (IVIG) in dermatomyositis: clinical responses and effect on sIL-2R levels.

Authors:  I Göttfried; A Seeber; B Anegg; A Rieger; G Stingl; B Volc-Platzer
Journal:  Eur J Dermatol       Date:  2000 Jan-Feb       Impact factor: 3.328

Review 6.  Corticosteroids versus intravenous immune globulin for the treatment of acute immune thrombocytopenic purpura in children: a systematic review and meta-analysis of randomized controlled trials.

Authors:  Carolyn E Beck; Paul C Nathan; Patricia C Parkin; Victor S Blanchette; Colin Macarthur
Journal:  J Pediatr       Date:  2005-10       Impact factor: 4.406

Review 7.  Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines.

Authors:  M C Dalakas
Journal:  Muscle Nerve       Date:  1999-11       Impact factor: 3.217

Review 8.  The use of intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: evidence-based indications and safety profile.

Authors:  Marinos C Dalakas
Journal:  Pharmacol Ther       Date:  2004-06       Impact factor: 12.310

Review 9.  Intravenous immunoglobulin for suspected or subsequently proven infection in neonates.

Authors:  A Ohlsson; J B Lacy
Journal:  Cochrane Database Syst Rev       Date:  2004

Review 10.  Intravenous immunoglobulin for preventing infection in preterm and/or low-birth-weight infants.

Authors:  A Ohlsson; J B Lacy
Journal:  Cochrane Database Syst Rev       Date:  2004
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  8 in total

1.  Dealing With Immunoglobulin Shortages: A Rationalization Plan From Evidence-Based and Data Collection.

Authors:  Gerard Solís-Díez; Marta Turu-Pedrola; Marta Roig-Izquierdo; Corinne Zara; Antoni Vallano; Caridad Pontes
Journal:  Front Public Health       Date:  2022-05-19

2.  Prescribing Practices of Intravenous Immunoglobulin in Tertiary Care Hospitals in Malaysia: A Need for a National Guideline for Immunoglobulin Use.

Authors:  Jian Lynn Lee; Shamin Mohd Saffian; Mohd Makmor-Bakry; Farida Islahudin; Hamidah Alias; Adli Ali; Noraida Mohamed Shah
Journal:  Front Pharmacol       Date:  2022-06-09       Impact factor: 5.988

3.  Clinical applications of immunoglobulin: update.

Authors:  Marcia Cristina Zago Novaretti; Carla Luana Dinardo
Journal:  Rev Bras Hematol Hemoter       Date:  2011

4.  Use of Polyclonal Intravenous Immunoglobulin at a Paediatric Referral Hospital in South Africa Between 2009 and 2012.

Authors:  Shenaaz Raiman; Stephen E Knight; Brian Eley; Tyson B Welzel
Journal:  J Clin Immunol       Date:  2015-09-14       Impact factor: 8.317

5.  Predicting Factors for the Pattern of Intravenous Immunoglobulin Utilization in a Middle Eastern University Hospital.

Authors:  Zeinab Fakhari; Shadi Farsaei; Ali Mohammad Sabzghabaee
Journal:  J Res Pharm Pract       Date:  2018 Oct-Dec

6.  Single-Center Experience of Outcomes and Prescribing Patterns of IV Immunoglobulin Use in Critically Ill Patients.

Authors:  Heather Torbic; Sinan Samir Abdul-Wahab; Sravanthi Ennala; Nagamani Guduguntla; Xiaozhen Han; Xiaofeng Wang; Abhijit Duggal; Sudhir Krishnan
Journal:  Crit Care Explor       Date:  2021-01-11

7.  Effects of the Off-Label Drug Prescription in the Paediatric Population in Spain from the Adoption of the Latest European Regulation: A Pre-Post Study.

Authors:  Irene Lizano-Díez; Itziar Aldalur-Uranga; Carlos Figueiredo-Escribá; Cecilia F Lastra; Eduardo L Mariño; Pilar Modamio
Journal:  Pharmaceutics       Date:  2021-04-20       Impact factor: 6.321

8.  Outcomes of off-label drug uses in hospitals: a multicentric prospective study.

Authors:  I Danés; A Agustí; A Vallano; C Alerany; J Martínez; J A Bosch; A Ferrer; L Gratacós; A Pérez; M Olmo; S M Cano Marron; A Valderrama; X Bonafont
Journal:  Eur J Clin Pharmacol       Date:  2014-09-09       Impact factor: 2.953

  8 in total

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