Evaluation of the Immunoglobulin Use in Inflammatory Systemic and Immuno-Mediated Illnesses in a Tertiary Hospital

The object of this study is to assess the IvIg (intravenous immunoglobulin) use in inflammatory systemic and immune-mediated illnesses, in patients older than 18 years in a tertiary hospital. The assessment also intends to ensure if the clinical indications matched with the evidence-based clinical guidelines recommendations of use. Analytical, observational, transversal and retrospective study carried out during 2012. Patients with inflammatory systemic and immuno-mediated illnesses, older than 18 years old, were included. The data collected were: age, sex, number of administrations, dosage, frequency, commercial brand and the indication for what the IvIg treatment has been prescribed. As a reference guide the British Health Department Clinical Guidelines for Immunoglobulin Use (2nd edition, 2008, and 2nd edition update 2011) and its Spanish adaption were used. The IvIg treatment was justified by a grade of recommendation A, B or C in 41% of the indications. Thus in 59% (grey indications or unclear diagnosis) the IvIg use would be questionable because of its weak evidence. It was found one indication for what the prescription of IvIg was clearly not recommended. The inflammatory systemic and immune-mediated diseases include many pathologies for what the IvIg use has not been properly studied. There is a need of consensus guidelines for IvIg use to guide doctors and pharmacists in their clinical practice. Moreover, it is important to prioritize which indications and circumstances are of first importance to have their supply guaranteed.