A Global Analysis of The Use of Immunoglobulin, Shortages in Supply, and Mitigating Measures: A Survey of Hospital Providers (a BEST Collaborative Study)

Author: So-Osman, C; Delaney, M; Fung, M; Lu, W; Murphy, M; Sasongko, PL; Tiberghien, P; Tinmouth, A

Affiliations: Sanquin Blood Supply, Dept Transfus Med, Rotterdam, Netherlands. Erasmus MC, Dept Hematol, Rotterdam, Netherlands. Childrens Natl Hosp, Div Pathol & Lab Med, Washington, DC USA. Univ Vermont, Ctr Hlth Care Management, Dept Pathol & Lab Med, Burlington, VT USA. Mayo Clin, Rochester, MN USA. Oxford Univ Hosp, Natl Hlth Serv Blood & Transplant, Oxford, England. Univ Oxford, Oxford, England. Sanquin Res, Dept Donor Med Res, Amsterdam, Netherlands. Etab Francais Sang, La Plaine St Denis, France. Franche Comte, EFS, INSERM, UMR RIGHT, Besancon, France. Univ Ottawa, Dept Med, Div Hematol, Ottawa, ON, Canada.

Publication: Transfusion. 2024

Abstract: BACKGROUND: Immunoglobulin (IG) therapy is widely used to treat primary and secondary immune deficiencies and as immunomodulatory agent for various disorders. There is great concern that shortages of IG may rise, potentially affecting medical treatment options. STUDY DESIGN AND METHODS: An international survey was developed to study how intravenous immunoglobulins (IVIGs) are used and managed within hospitals in case of shortages. Study data were collected and managed using REDCap electronic data capture tools hosted by the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. The survey was directed to hospital pharmacists and blood bank transfusion professionals and disseminated through members of the BEST Collaborative network. RESULTS: Survey respondents from institutions in the USA, Canada, Europe, Japan, and Australia (n = 13) confirmed that the primary specialties utilizing IG are neurology, hematology, and immunology. More than 60% of respondents reported IG supply shortages, but mitigation strategies were not well developed. DISCUSSION: As IG is the leading driver in plasma demand, more studies are needed to understand current and future demand for IG from the clinical perspective. Necessity lies in establishing clinical guidance to address shortages.