ABSTRACT Background: Intravenous immunoglobulin (IVIG) is a plasma product which has been extracted from the serum of thousands of donors. It has been approved by the federal drug authority (FDA) either as an immune-replacement or immune-modulation therapy. The use of IVIG has recently been extended to multiple diseases, some of which are still not approved by the FDA showing a good clinical response. There are limited data published from Saudi Arabia reporting the use of IVIG therapy encompassing clinical indicators, dosing protocols, and related adverse events. Aim: The Aim if this study was to evaluate the prevalence and frequency of IVIG therapy among pediatric patients and to evaluate the indications and subspecialties prescribed the IVIG therapy. Methods: This retrospective study included the patients who received treatment between March 2023 and March 2025. The data extracted from medical records included demographics as well as variables related to IVIG therapy. Results: There were 229 patients who received IVIG therapy during the study period. There were 38.4% of patients <2 years old, and 22.7% of patients were between 2.1 and 5 years old. The highest prescription of IVIG was by neonatology. The most common indication was idiopathic thrombocytopenic purpura (25.85%). Dose accuracy was significantly affected by the category of IVIG, in which accuracy was compromised significantly for Category C IVIG therapy compared to Category A and Category B ( P < 0.001). Conclusion: In our study we observe that there are multiple departments are using IVIG for off-label indications that is NOT approved officially by the FDA which could be risky for the patients and also having financial burden on the hospital. It was required to take corrective measures to improve this practice.
Alkhuwaiter et al. (Thu,) studied this question.