Background and importance Non-specific intravenous immunoglobulins are widely used in hospitals to treat different pathologies. Previous studies concluded that many were off-label uses. This makes it necessary to analyse the use of immunoglobulins in our patients.
Aim and objectives The aim was to examine the use of non-specific intravenous immunoglobulins in hospitalised and ambulatory patients in a tertiary hospital, as well as the prevalence of off-label uses.
Material and methods This observational, retrospective study included patients treated with intravenous immunoglobulins from July 2018 to July 2019. Collected data were sex, age, indication and dose. Data were extracted from the clinical history.
Results In our study, 158 patients (50.63% men) with a median age of 66 (55–77) years were included: 54.43% (n=86) ambulatory and 45.57% (n=72) hospitalised patients.
The most frequent indications were common variable immunodeficiency (CVID) in 13.92% (n=22), secondary immunodeficiency in 12.02% (n=19) and idiopathic thrombocytopenic purpura (ITP) in 8.86% (n=14) of patients. Applying this analysis to patient subgroups, for ambulatory patients, the indications were CVID in 25.58% (n=22), secondary immunodeficiency in 13.95% (n=12) and polyneuropathy in 4.65% (n=4) while in hospitalised patients the indications were ITP in 19.44% (n=14), secondary immunodeficiency in 9.72% (n=7), and myasthenia gravis in 6.94% (n=59). The prevalence of off-label uses was 44.94% (n=71), with 52.11% (n=37) in hospitalised patients.
Conclusion and relevance Although the most common uses of immunoglobulins in our hospital were for authorised indications, the off-label uses were highly prevalent (44.94% (n=71)). We must ensure, in the hospital pharmacy services, rational use of immunoglobulins. Therefore, it is necessary to implement a protocol for the use of intravenous immunoglobulins by the pharmacy and therapeutics committee. For implementation of this protocol, it is necessary to evaluate the scientific evidence of off-label uses, as well as adaptation to clinical practice guidelines.
References and/or acknowledgements No conflict of interest.
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