A Multicenter Drug Use Surveillance of Intravenous Immunoglobulin Utilization in US Academic Health Centers

Chen, Connie; Danekas, Lynne H; Ratko, Thomas A; Vlasses, Peter H.; Matuszewski, Karl A.

doi:10.1345/aph.19252

Cited by 57 publications

(48 citation statements)

References 1 publication

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“…Of the 130 (52%) patients who received IVIg for an off-label indication, 27% were in a "currently not supported" group, based on the more recent guidelines presented here. 16 In comparison with the other studies, the use of IVIg for treating neurologic conditions in this study was notably less (16.7% of patients). Chen et al had one of the oldest sampling periods referenced, and the use of IVIg as a treatment intervention was likely less recognized at that time.…”

Section: Pendergrast Et Al (2005) Evaluated the Use Of Ivig In 429contrasting

confidence: 57%

“…An observational study by Chen et al (2000) of IVIg use in 12 U.S. academic centers in 1996 assessed the inpatient use of IVIg in 251 patients. 16 The authors also evaluated the FDA label status and supporting evidence for requests using the 1995 United Health Consortium guidelines.…”

Section: Pendergrast Et Al (2005) Evaluated the Use Of Ivig In 429mentioning

confidence: 99%

“…16 The authors also evaluated the FDA label status and supporting evidence for requests using the 1995 United Health Consortium guidelines. The study found that 43% of IVIg use was for labeled indications.…”

Section: Pendergrast Et Al (2005) Evaluated the Use Of Ivig In 429mentioning

confidence: 99%

See 2 more Smart Citations

Descriptive Review and Analysis of Immunoglobulin Utilization Management from 2,548 Prior Authorization Requests

Tonkovic¹,

Rutishauser²

2014

JMCP

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Section: Pendergrast Et Al (2005) Evaluated the Use Of Ivig In 429contrasting

confidence: 57%

Section: Pendergrast Et Al (2005) Evaluated the Use Of Ivig In 429mentioning

confidence: 99%

See 1 more Smart Citation

Descriptive Review and Analysis of Immunoglobulin Utilization Management from 2,548 Prior Authorization Requests

Tonkovic¹,

Rutishauser²

2014

JMCP

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“…Off-label use of IVIG, however, is widespread [366,367]. In practice, IVIG is considered to be an alternative to plasmapheresis.…”

Section: Intravenous Immunoglobulinmentioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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“…However, there are still substantial differences in the amounts of Ig prescribed by individual practitioners, and it is important to understand the utilization of Ig in the treatment of PIDD in the United States. Most previous publications on the use of Ig have focused on global Ig use in hospital settings [1,[10][11][12]. As 45.1 % of all subjects with PIDD are likely to receive Ig treatment [13], and in most cases in the home, we examined the demographics, products, and dosing of Ig used in the home care setting for a large cohort of subjects with PIDD in the United States.…”

Section: Introductionmentioning

confidence: 99%

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

Huang

Cunningham‐Rundles

2012

Journal of Allergy and Clinical Immunology

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Purpose-Utilization reports on immunoglobulin (Ig) use for immunodeficiency in the United States (U.S.) have focused on prescribing practices in hospitals. There have been no large-scale reports on Ig use for immune deficiency in the home. We investigated the use of Ig in 3,187 subjects diagnosed with primary immunodeficiency.Methods-Cross-sectional data on 4,580 subjects in the U.S. receiving Ig in 2011 was obtained from a major home care provider. Demographics, route, dose, and frequency of Ig use by subjects with ICD-9 coded primary immunodeficiencies were analyzed.Results-Of 4,580 subjects, 3,187 had ICD-9 codes suggesting primary immunodeficiencies; 1,939 (60.8 %) were females and 1,248 (39.2 %) were males, with age ranging from 0 to 95 years. The predominant diagnoses were: common variable immunodeficiency (279.06; n =1,764; 55.3 %), hypogammaglobulinemia (279.00; n=635; 19.9 %), unspecified immunity deficiency (279.3; n=286; 9 %), other selective Ig deficiencies (279.03; n=171; 5.4 %), and agammaglobulinemia (279.04; n=127; 4 %). 54 % of subjects received Ig by the subcutaneous (SC) route, and 46 % by intravenous (IV) route, with more SC use by older subjects. The mean dose prescribed was 483 mg/kg/month, but less Ig was ordered for subjects on SCIg (409 mg/kg/month), as compared to subjects on IVIg (568 mg/kg/month). A highly significant inverse correlation between increasing age and dosage of Ig ordered was found (P=<.0001).Conclusion-Analysis of home care use of Ig in primary immune deficiency revealed that the SC route was prescribed more than the IV route, especially for older patients. By either method of administration, less immunoglobulin was prescribed for older subjects.

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A Multicenter Drug Use Surveillance of Intravenous Immunoglobulin Utilization in US Academic Health Centers

Abstract: Our findings suggest that IVIG continues to be used to treat a wide variety of conditions not specified in the product label. Furthermore, a substantial proportion of the reported off-label uses are not recommended according to evidence-based guidelines.

Cited by 57 publications

References 1 publication

Descriptive Review and Analysis of Immunoglobulin Utilization Management from 2,548 Prior Authorization Requests

Descriptive Review and Analysis of Immunoglobulin Utilization Management from 2,548 Prior Authorization Requests

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

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