The therapeutic role of IVIG awaits confirmation for most off-label use. In spite of this, many of these off-label indications already have adequate published information available to develop guideline recommendations on the appropriateness of their use. One major concern is widespread IVIG use in areas of unsubstantiated clinical benefit. This could lead to product wastage, which may impact on patient care in times of product shortage or be a root cause of future shortages. Further, this widespread use could also result in an unwarranted economic burden on the Canadian taxpayers. However, this study clearly demonstrated this not to be the case and that the majority of IVIG is in fact being used judiciously and in areas where the Canadian guidelines consider it proper. This is further substantiated by the fact that over the three-year period of study, the level of inappropriate use was consistently low (4% to 5.4%). buy ortho tri-cyclen
Based on guideline definition, there is a high proportion of appropriate use of IVIG in both the adult and pediatric populations. The incidence of licensed use is much higher in pediatrics than in adults. In the adult population, hematologists and neurologists are the main prescribers of IVIG. Prospective studies of use may be warranted in the future to continue surveillance of appropriate use.