Background Intravenous immunoglobulins (IVIG) are prepared in the sterile area of a Pharmacy Service (PS).
Purpose To analyse IVIG prescriptions before and after an update of the IVIG protocol.
Materials and methods Retrospective study to compare IVIG prescribed in period 1 (January 2012–March 2012) with those prescribed in period 2 (January 2013–March 2013). The update of protocol was approved in January 2013. IVIG indications were classified according to level of evidence and the ideal weight-adjusted dose was established for each indication. Type of IVIG prescribed, dose (g/kg/day), total dose, medical service and indication were recorded.
Results 122 and 88 patients were treated with IVIG in period 1 and 2 respectively (82.0% and 72.0% throughout each period). The hospital services that prescribed more IVIG were in both periods Haematology (74.0% in period 1 and 70.0% in period 2) and Neurology (15.0% and 18.0% respectively). The main indication for IVIG was common variable immunodeficiency (CVID) (26.0% and 35.0% in period 1 and 2 respectively), followed by secondary immunodeficiency type LLC (17.0% and 16.0% respectively for the two periods). Other indications were primary immune thrombocytopenia (ITP) (20.0%), chronic polyradiculoneuritis (7.0%) and Burton’s syndrome (7.0%) during period 1 and chronic polyradiculoneuritis (10.0%) and PTI (8.0%) during period 2. The use of IVIG declined by a total of 16.5% (92,154 euros). It has declined in Burton’s syndrome patients (80.2%); in ITP patients (67.3%) because IVIG was approved only for those with severe bleeding (WHO bleeding scale grade >2) and in CLL patients (20.4%), for whom the IVIG dose was adjusted according to clinical infectious to maintain the concentration of IVIG >600 mg/ml.
Conclusions Updating the IVIG protocol has enabled IVIG to be used more efficiently. There has been a saving in the treatment of ITP and the administration of IVIG for PTI, LLC and Burton’s syndrome has decreased.
No conflict of interest.
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