IVIG Stewardship to Evaluate Outpatient Infusion Use
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Publication Date
2025
Abstract
Abstract: IVIG is an IV medicine that is made from human donor plasma and is approved to treat low Immunoglobulin G (IgG) serum levels to reduce the risk of infections. IgG is the most common antibody and is a part of the immune system to help protect against bacterial and viral infections. IVIG works by modulating cells in the immune system to help replenish low IgG levels. Current CDC and NCCN guidelines recommend IVIG replacement for IgG levels < 500 mg/dL for hypogammaglobulinemia caused by different disease states such as CLL, multiple myeloma, B-cell malignancies. Based on current observations and practices at Providence Franz Cancer Center, IVIG is administered at regular intervals without regard to IgG levels. With anticipation of increased use of IVIG with recent approval of multiple bispecific antibodies that recommend using IVIG prophylaxis, a more formal use criteria protocol for IVIG is necessary to assure appropriate use and avoid unnecessary treatment and cost for patients. Eligible patients ≥18 years old who received IVIG between January 2023 to January 2025 at Providence Franz Cancer Center and Providence Outpatient Infusion Center. Patients with hypogammaglobulinemia, CLL, multiple myeloma, immunodeficiency, follicular lymphoma, diffuse large B-cell lymphoma. Data collection through SlicerDicer with IVIG administration from January 2023 to January 2025 and manual chart review to obtain dose and frequency of IVIG and IgG levels as available. Project evaluates use of IVIG and compliance with IgG level-based dosing to identify if administration is appropriate based on current recommendations. The aim of the project is to evaluate overall IVIG use, and patients’ cost savings and treatment burden associated with IgG level-based dosing. Preliminary results will be presented. Results and conclusions will be shared when the project is completed. (IRB exempt).
Specialty/Research Institute
Graduate Medical Education
