title: Use of intravenous immunoglobulin in an Asian paediatric population over a 10-year period.
abstract: OBJECTIVE
  There is a paucity of data on the pattern of intravenous immunoglobulin (IVIG) usage in the paediatric population. This study aimed to assess the prevalence, trends, indications and burden of cost of IVIG usage in the Singaporean paediatric population.
  
  
  METHODS
  Pharmacy data of all IVIG prescriptions between 2000 and 2009 in the two major paediatric public hospitals in Singapore were retrospectively reviewed. Each prescription was cross-referenced with the patient's hospital records to confirm the administration of IVIG and indication of use.
  
  
  RESULTS
  Over the 10-year period, a total 78,155 g of IVIG valued at an estimated $5.2 million was prescribed. There was an increasing trend of 445.6 g/year (P = 0.02) over this period. Analysis of patients showed that the most common indication for IVIG use was Kawasaki disease, both in terms of the proportion of patients (60%) and amount of IVIG used (34%). Kawasaki disease was also the only indication where there were significant increasing trends in both patient numbers (7.4 patients/year) and amount of IVIG used (247.5 g/year). The indications with the highest amount of IVIG used per patient were for conditions related to primary immunodeficiency diseases and stem cell transplantation, where repeat transfusions were required. More than 75% of indications were Food and Drug Administration approved.
  
  
  CONCLUSIONS
  Albeit substantial and increasing, the use of IVIG in Singaporean children is mostly evidence based.
authors.affiliation: Department of Paediatrics, National University of Singapore, Singapore.
authors.forename: Jethro
authors.initials: J
authors.lastname: Wu
authors.forename: Alison Joanne
authors.initials: AJ
authors.lastname: Lee
authors.forename: Anne Eng-Neo
authors.initials: AE
authors.lastname: Goh
authors.forename: Moira
authors.initials: M
authors.lastname: Chia
authors.forename: Christopher
authors.initials: C
authors.lastname: Ho
authors.forename: Jackelyn Laycano
authors.initials: JL
authors.lastname: Bugarin
authors.forename: Lynette Pei-Chi
authors.initials: LP
authors.lastname: Shek
authors.forename: Yiong-Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Bee-Wah
authors.initials: BW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006776:Hospitals, Pediatric; D006779:Hospitals, Public; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012846:Singapore
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: FDA approved; Kawasaki disease; indication; intravenous immunoglobulin (IVIG); trend