Immunoglobulin use in immune deficiency in the UK: a report of the UKPID and National Immunoglobulin Databases
Immunoglobulin use in immune deficiency in the UK: a report of the UKPID and National Immunoglobulin Databases
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英国免疫球蛋白在免疫缺陷中的应用：UKPID 和国家免疫球蛋白数据库的报告
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发表时间：
2018
期刊：
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通讯作者：
M. Buckland
中科院分区：
文献类型：
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作者：
B. Shillitoe;R. Hollingsworth;M. Foster;T. Garcez;D. Guzman;J. Edgar;M. Buckland
摘要由于需求增加、成本增加和供应多变，英国免疫球蛋白的供应面临压力。本文介绍了免疫球蛋白替代疗法(IGRT)在原发免疫缺陷(PID)和继发性免疫缺陷(SID)中的应用，以帮助正在进行的英国免疫球蛋白供应规划。对国家免疫球蛋白数据库和英国免疫球蛋白注册进行了回顾分析。总共有3,222名患者登记为因免疫缺陷而接受IGRT。主要是抗体障碍构成了最大的诊断类别(61%的患者)。2015/16年度免疫缺陷IGRT的总费用为40,673,350 GB；每个中心的年均费用为1,099,254 GB，每个PID患者的平均费用为12,124 GB。SCIg占IGRT的43.8%和50.1%，家庭治疗分别占国家免疫球蛋白数据库和UKPID注册治疗地点的42.7%和57.5%。2015/16年度SID的免疫球蛋白使用量比上一财政年度增加了24%。免疫学需求增加的总体趋势也反映在其他专业上，最明显的是神经学和血液学。这些数据是针对免疫缺陷的IGRT的第一次全国性概述，为临床医生和政策制定者在英国免疫球蛋白供应的持续管理中提供了宝贵的资源。
ABSTRACT Supply of immunoglobulin in the UK faces pressures due to increasing demand, cost and variable supply. This paper describes immunoglobulin replacement therapy (IGRT) in primary immunodeficiency (PID) and secondary immunodeficiency (SID) to assist in the ongoing planning of UK immunoglobulin provision. A retrospective analysis of the National Immunoglobulin Database and the UKPID registry was carried out. In total, 3,222 patients are registered as receiving IGRT for immunodeficiencies. Predominately antibody disorders made up the largest diagnostic category (61% of patients). The total cost of IGRT for immunodeficiency for 2015/16 was £40,673,350; an average annual cost of £1,099,254 per centre and £12,124 per PID patient. SCIg accounted for 43.8% and 50.1% of IGRT, with home therapy accounting for 42.7% and 57.5% of place of therapy in the National Immunoglobulin Database and UKPID registry respectively. In 2015/16 use of immunoglobulin in SID increased by 24% over the previous financial year. The overall trends of increasing demand in immunology are mirrored in other specialties, most notably neurology and haematology. These data are the first national overview of IGRT for immunodeficiencies, providing a valuable resource for clinicians and policy makers in the ongoing management of UK immunoglobulin supply.