Prescribing intravenous immunoglobulin: summary of Department of Health guidelines

doi:10.1136/bmj.a1831

Published 20 October 2008, doi:10.1136/bmj.a1831
Cite this as: BMJ 2008;337:a1831

Practice

Guidelines

Prescribing intravenous immunoglobulin: summary of Department of Health guidelines

Drew Provan, consultant haematologist¹, Helen M Chapel, consultant immunologist², W A Carrock Sewell, consultant immunologist and visiting professor of immunology³, Denise O’Shaughnessy, senior medical adviser⁴, on behalf of the UK Immunoglobulin Expert Working Group

¹ Department of Haematology, Barts and the London NHS Trust, The Royal London Hospital, London E1 2ES, ² Nuffield Department of Medicine, University of Oxford, and Oxford Radcliffe Hospitals NHS Trust, Oxford OX3 9DU, ³ Scunthorpe General Hospital, North Lincolnshire and Goole NHS Trust, North Lincolnshire DN15 7BH, ⁴ Blood Policy Unit, Department of Health, London SE1 6LH

Correspondence to: D Provan a.provan@virgin.net

The first 150 words of the full text of this article appear below.

Therapeutic immunoglobulin, a preparation of normal human polyclonalimmunoglobulin G derived from pooled human plasma, has becomean important treatment option in a range of medical conditionsbeyond its use in immune deficiencies, particularly autoimmuneand acute inflammatory diseases.¹ For some time, concern hasbeen expressed over the availability of immunoglobulin. Severeglobal supply shortages began in the late 1990s, when demandexceeded supply by up to 30%,² and production problems specificto the United Kingdom have curtailed supply. This supply shortagehas been compounded by increasing use in established indications³and widespread off-label prescribing.⁴ To ensure that supplyis maintained, even in times of acute shortage, for the patientsconsidered to be the highest priority because of a risk to lifewithout treatment, potential prescribers of immunoglobulin needhelp in identifying treatment indications for which its useis appropriate. This article summarises the most recent Departmentof Health guidelines . . . [Full text of this article]

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