Department of Pulmonology, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2019 May 1;22(5):232-235.
Intravenous immunoglobulin (IVIG) is an immunomodulating agent that has several actions. The aim of this study was to investigate the indications of IVIG according to available evidence and the cost in our center.
This retrospective study was conducted between September 2017 and June 2018 at a teaching hospital affiliated with Iran University of Medical Sciences, Tehran, Iran. Patients' demographic data and disease, indication for IVIG use, its dosage and treatment regimen and previous and concurrent treatments were assessed. The collected data were compared with the present criteria for the pattern of IVIG usage. The last version of Lexicomp® was used as the reference for indications of the administrated drug and its dosage.
A total of 119 patients received IVIG during the study period. The wards with the most frequent IVIG prescription were the neurology (46.2%) and neonatal intensive care unit (21%). The most common reasons of IVIG therapy were various inflammatory neurological disorders. IVIG was used in 22, 43 and 54 cases according to on-label, off- label and other indications, respectively. The total price was higher for off-label indications for IVIG ($254343.75) than on-label indications ($152625). As well, $107250 was exhausted for cases in which there was not sufficient evidence.
One important aspects of this study was the use of IVIG in cases other than on-label indications. Although a number of studies support IVIG therapy in some diseases, further trials are needed to establish efficacy and safety in these fields.
静脉注射免疫球蛋白（IVIG）是一种具有多种作用的免疫调节剂。本研究旨在根据现有证据和我们中心的成本来调查 IVIG 的适应证。
这是一项回顾性研究，于 2017 年 9 月至 2018 年 6 月在伊朗德黑兰的伊朗医科大学附属医院进行。评估了患者的人口统计学数据和疾病、IVIG 使用的适应证、剂量和治疗方案以及先前和同时进行的治疗。将收集到的数据与 IVIG 使用模式的现行标准进行比较。Lexicomp®的最新版本被用作所使用药物的适应证及其剂量的参考。
在研究期间，共有 119 名患者接受了 IVIG 治疗。开具 IVIG 处方最多的病房是神经内科（46.2%）和新生儿重症监护病房（21%）。IVIG 治疗最常见的原因是各种炎症性神经疾病。根据标签内、标签外和其他适应证，IVIG 分别用于 22、43 和 54 例患者。IVIG 标签外适应证的总费用（$254343.75）高于标签内适应证（$152625）。同样，由于缺乏足够的证据，有 107250 美元用于这些病例。
本研究的一个重要方面是使用 IVIG 治疗标签外适应证。尽管许多研究支持 IVIG 治疗某些疾病，但仍需要进一步的试验来确定这些领域的疗效和安全性。
