Summary of Key Changes to the Criteria for the clinical use of intravenous immunoglobulin in Australia Second Edition Indications that have been removed from the IVIg Criteria Chapter Indication Change The removal of the indication is based on the latest published clinical literature, which concludes that the routine prophylactic treatment of HSCT with IVIg is not supported in the absence of Haemopoietic stem cell hypogammaglobulinaemia. transplantation (HSCT) for 6 prevention of GvHD in high risk Patients with hypogammaglobulinaemia may still be eligible to Allogeneic HSCT receive IVIg under the acquired hypogammaglobulinaemia indication. Page 148, 2007 Criteria IVIg is no longer funded for the treatment of sepsis in neonates. The 2011 International Neonatal Immunotherapy Study found that therapy with IVIg had no effect on the outcomes of 7 Sepsis - neonatal suspected or proven neonatal sepsis. Page 193, 2007 Criteria. New Indications Chapter Indication Change New indication. encephalopathy ‘Hashimoto encephalopathy associated with autoimmune thyroiditis). IVIg is not supported as first-line treatment, because preferable alternative treatments are available. IVIg 7 Hashimoto encephalopathy may be considered in exceptional circumstances where there is progressive neurologic decline despite appropriate steroid therapy.’ Page 197, IVIg Criteria Second Edition. New indication. encephalitis - nonparaneoplastic. ‘Limbic There appears to be a role for IVIg in nonparaneoplastic limbic encephalitis associated with neuronal antibodies to cell Limbic encephalitis - 7 surface antigens. This includes VGKC antibodies, as well as nonparaneoplastic NMDA receptor antibodies and AMPA receptor antibodies.’ Page 198, IVIg Criteria Second Edition. New indication. gangrenosum. Use of IVIg is ‘Pyoderma limited to patients with significant pyoderma gangrenosum, diagnosed by a dermatologist, unresponsive to corticosteroids and other immunosuppressive agents. Induction dose, then 7 Pyoderma gangrenosum maintenance therapy up to 6 months. Should be ceased in patients who fail to respond after 3 cycles.’ Page 205, IVIg Criteria Second Edition.
Summary of Key Changes to the Criteria for the clinical use of intravenous immunoglobulin in Australia Second Edition Indications that have been removed from the IVIg Criteria Chapter Indication Change 6 Haemopoietic stem cell transplantation (HSCT) for prevention of GvHD in high risk Allogeneic HSCT The removal of the indication is based on the latest published clinical literature, which concludes that the routine prophylactic treatment of HSCT with IVIg is not supported in the absence of hypogammaglobulinaemia. Patients with hypogammaglobulinaemia may still be eligible to receive IVIg under the acquired hypogammaglobulinaemia indication. Page 148, 2007 Criteria 7 Sepsis - neonatal IVIg is no longer funded for the treatment of sepsis in neonates. The 2011 International Neonatal Immunotherapy Study found that therapy with IVIg had no effect on the outcomes of suspected or proven neonatal sepsis. Page 193, 2007 Criteria. New Indications Chapter Indication Change 7 Hashimoto encephalopathy New indication. ‘Hashimoto encephalopathy encephalopathy associated with autoimmune thyroiditis). IVIg is not supported as first-line treatment, because preferable alternative treatments are available. IVIg may be considered in exceptional circumstances where there is progressive neurologic decline despite appropriate steroid therapy.’ Page 197, IVIg Criteria Second Edition. 7 Limbic encephalitis - nonparaneoplastic New indication. ‘Limbic encephalitis - nonparaneoplastic. There appears to be a role for IVIg in nonparaneoplastic limbic encephalitis associated with neuronal antibodies to cell surface antigens. This includes VGKC antibodies, as well as NMDA receptor antibodies and AMPA receptor antibodies.’ Page 198, IVIg Criteria Second Edition. 7 Pyoderma gangrenosum New indication. ‘Pyoderma gangrenosum. Use of IVIg is limited to patients with significant pyoderma gangrenosum, diagnosed by a dermatologist, unresponsive to corticosteroids and other immunosuppressive agents. Induction dose, then maintenance therapy up to 6 months. Should be ceased in patients who fail to respond after 3 cycles.’ Page 205, IVIg Criteria Second Edition.
nba-ivig-criteria-for-use-2nd-edition-summary-of-changes.docx