Investigating the rational use of intravenous immunoglobulin (IVIG) in Tabriz Children's Hospital:: A Cross-Sectional Study

Introduction: Intravenous immunoglobulin (IVIG) plays a controversial role in the treatment of various types of diseases. Therefore, careful examination of its consumption pattern is necessary due to not only its limited resources and high prices, but also repeated non-approved uses without sufficient clinical evidence. Unfortunately, there is not enough information about its use in Iran, particularly in the field of children. Objectives: The present study was designed to examine the pattern of IVIG use in patients admitted to one of the university centers (Tabriz Pediatric Hospital). Additionally, the data were compared to the International standard guidelines. Method: This descriptive study was conducted in a cross-sectional and prospective methodology. Patients who received IVIG from December ۲۰۲۳ to May ۲۰۲۴ were selected from different departments of Tabriz Children Hospital and enrolled the study. The information collected in this study include patient demographics, indications, drug use regimen, side effects and prescribing specialists. According to standard guidelines the user IVIG in this study was in three main groups, FDA approved, Off-labeled with support and Off-labeled without support. Results: Among ۱۱۷ included patients with the mean age of ۷ years old, IVIG was given to ۷۹ patients (۶۷.۵%) by FDA approved indications. Furthermore, ۲۳۵۶.۵g IVIG was used during this study with an estimated cost of ۳۵۳۴۷۵۰۰۰۰ Iranian Rials, whereas ۴% of which related to inappropriate indications. Immunologists (۵۳%) and neurologists (۲۲.۲%) were the most frequent prescribers, and the leading indications for IVIG use was Primary immunodeficiency (۴۷.۸%). Moreover, ۶.۸% of patients experienced systemic adverse reactions during IVIG administration. Conclusion: Although, the major use of IVIG in this study has been according to the standard guidelines, but in limited cases it was prescribed for inappropriate indications. Therefore, it seems that regional collaborative strategy to monitor IVIG use according standard protocol in institutes is necessary.

کلیدواژه ها:

Intravenous Immunoglobulin ، Rational prescription ، Drug Use Evaluation