PMID- 20204337 OWN - NLM STAT- MEDLINE DCOM- 20100726 LR - 20220331 IS - 1432-1041 (Electronic) IS - 0031-6970 (Linking) VI - 66 IP - 6 DP - 2010 Jun TI - Use of non-specific intravenous human immunoglobulins in Spanish hospitals; need for a hospital protocol. PG - 633-41 LID - 10.1007/s00228-010-0800-y [doi] AB - Intravenous immunoglobulin (IVIG) use in non-approved indications, the increase in consumption and its high cost recommend rationalisation in its utilisation. AIMS: To assess the use of IVIG in Spanish hospitals. METHODS: An observational, prospective and multicentre drug utilisation study was conducted in 13 tertiary Spanish hospitals. Data were collected for 3 months in patients receiving any IVIG. Patient demographics, indication for IVIG use, dosage regimen and cost of treatment were collected. RESULTS: Five hundred and fifty-four patients (mean age of 52 years) were included in the study. A total of 1,287 prescriptions were administered, and the average number of prescriptions per patient was 2.3. The mean daily dose was 24 g (range 0.6-90 g). Overall, IVIG was prescribed for authorised indications in 335 patients (60%) with 953 prescriptions (74%), for non-authorised indications with scientific evidentiary support in 86 patients (16%) with 137 prescriptions (11%), and non-authorised and non-accepted indications in 133 patients (24%) with 197 prescriptions (15%). The most frequent authorised indications were primary and secondary immunodeficiencies, and the most frequent non-authorised and non-accepted indications were multiple sclerosis and bullous dermatosis. The mean cost of IVIG per patient for authorised indications was 2,636.2 , non-authorised indications with scientific support 5,262.1 and non-accepted indications 3,555.8 . CONCLUSIONS: IVIG is prescribed for a significant number of non-authorised and non-accepted indications with a notable cost. There is an important variability in IVIG prescriptions between hospitals, indicating room for improvement in IVIG use and the need for a consensus of protocol use. FAU - Ruiz-Antoran, Belen AU - Ruiz-Antoran B AD - Clinical Pharmacology Department, Puerta de Hierro Majadahonda University Hospital, C/ Manuel de Falla 1, 28222, Majadahonda, Madrid, Spain. bruiz.hpth@salud.madrid.org FAU - Agusti Escasany, Antonia AU - Agusti Escasany A FAU - Vallano Ferraz, Antoni AU - Vallano Ferraz A FAU - Danes Carreras, Imma AU - Danes Carreras I FAU - Riba, Neus AU - Riba N FAU - Mateu Escudero, Silvia AU - Mateu Escudero S FAU - Costa, Joan AU - Costa J FAU - Sanchez Santiago, M Blanca AU - Sanchez Santiago MB FAU - Laredo, Leonor AU - Laredo L FAU - Duran Quintana, Jose Antonio AU - Duran Quintana JA FAU - Castillo, Juan Ramon AU - Castillo JR FAU - Abad-Santos, Francisco AU - Abad-Santos F FAU - Payares Herrera, Concepcion AU - Payares Herrera C FAU - Sadaba Diaz de Rada, Belen AU - Sadaba Diaz de Rada B FAU - Gomez Ontanon, Eugenio AU - Gomez Ontanon E LA - eng PT - Journal Article PT - Multicenter Study DEP - 20100305 PL - Germany TA - Eur J Clin Pharmacol JT - European journal of clinical pharmacology JID - 1256165 RN - 0 (Immunoglobulins, Intravenous) RN - 0 (Immunologic Factors) SB - IM MH - Adult MH - Aged MH - *Drug Costs MH - Drug Utilization/standards/*statistics & numerical data MH - Empathy MH - Female MH - Hospitals, General/*statistics & numerical data MH - Humans MH - Immunoglobulins, Intravenous/administration & dosage/adverse effects/*economics/*therapeutic use MH - Immunologic Factors/administration & dosage/adverse effects/*economics/*therapeutic use MH - Male MH - Middle Aged MH - Off-Label Use/*statistics & numerical data MH - Prospective Studies MH - Spain EDAT- 2010/03/06 06:00 MHDA- 2010/07/27 06:00 CRDT- 2010/03/06 06:00 PHST- 2009/09/08 00:00 [received] PHST- 2010/02/08 00:00 [accepted] PHST- 2010/03/06 06:00 [entrez] PHST- 2010/03/06 06:00 [pubmed] PHST- 2010/07/27 06:00 [medline] AID - 10.1007/s00228-010-0800-y [doi] PST - ppublish SO - Eur J Clin Pharmacol. 2010 Jun;66(6):633-41. doi: 10.1007/s00228-010-0800-y. Epub 2010 Mar 5.