eprintid: 10056808
rev_number: 20
eprint_status: archive
userid: 608
dir: disk0/10/05/68/08
datestamp: 2018-09-25 09:08:27
lastmod: 2021-10-12 22:20:12
status_changed: 2018-09-25 09:08:27
type: article
metadata_visibility: show
creators_name: Kinsella, JA
creators_name: Irani, SR
creators_name: Hollingsworth, R
creators_name: O'Shaughnessy, D
creators_name: Kane, P
creators_name: Foster, M
creators_name: Schott, JM
creators_name: Lunn, MP
title: Use of intravenous immunoglobulin for the treatment of autoimmune encephalitis: audit of the NHS experience
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D07
divisions: F86
keywords: autoimmune encephalitis, database, intravenous immunoglobulin, outcome
note: Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
abstract: OBJECTIVES: The treatments of limbic and other autoimmune encephalitis include immunosuppression, symptomatic treatment, and in the case of paraneoplastic syndromes, appropriate therapy for underlying neoplasms. When immunotherapy is considered, intravenous immunoglobulin is one option for treatment, either alone or in combination with corticosteroids. To date, however, evidence for the use of intravenous immunoglobulin in this context comes from case series/expert reviews as no controlled trials have been performed. We aimed to analyse the NHS England Database of intravenous immunoglobulin usage, which was designed to log use and guide procurement, to explore usage and therapeutic effect of intravenous immunoglobulin in autoimmune encephalitis in England. DESIGN: We conducted a retrospective audit and review of the NHS England Database on intravenous immunoglobulin use. Setting: NHS England Database of intravenous immunoglobulin use which covers secondary and tertiary care prescribing and use of intravenous immunoglobulin for all patients in hospitals in England. PARTICIPANTS: Hospital in-patients with confirmed or suspected autoimmune/limbic encephalitis between September 2010 and January 2017. RESULTS: A total of 625 patients who were 18 years of age or older were treated with intravenous immunoglobulin for autoimmune encephalitis, of whom 398 were determined as having 'highly likely' or 'definite' autoimmune/limbic encephalitis. Ninety-six percent were treated with a single course of intravenous immunoglobulin. The availability and accuracy of reporting of outcomes was very poor, with complete data only available in 27% of all cases. CONCLUSIONS: This is the first review of data from this unique national database. Whilst there was evidence for clinical improvement in many cases of patients treated with intravenous immunoglobulin, the quality of outcome data was generally inadequate. Methods to improve quality, accuracy and completeness of reporting are crucial to maximise the potential value of this resource as an auditing tool.
date: 2018-09
date_type: published
official_url: http://dx.doi.org/10.1177/2054270418793021
oa_status: green
full_text_type: pub
pmcid: PMC6122256
language: eng
primo: open
primo_central: open_green
article_type_text: Journal Article
verified: verified_manual
elements_id: 1584197
doi: 10.1177/2054270418793021
pii: 10.1177_2054270418793021
lyricists_name: Lunn, Michael
lyricists_name: Schott, Jonathan
lyricists_id: MLUNN80
lyricists_id: JMSCH12
actors_name: Cuccu, Clara
actors_id: CCCUC40
actors_role: owner
full_text_status: public
publication: JRSM Open
volume: 9
number: 9
pagerange: 1-5
event_location: England
issn: 2054-2704
citation:        Kinsella, JA;    Irani, SR;    Hollingsworth, R;    O'Shaughnessy, D;    Kane, P;    Foster, M;    Schott, JM;           Kinsella, JA;  Irani, SR;  Hollingsworth, R;  O'Shaughnessy, D;  Kane, P;  Foster, M;  Schott, JM;  Lunn, MP;   - view fewer <#>    (2018)    Use of intravenous immunoglobulin for the treatment of autoimmune encephalitis: audit of the NHS experience.                   JRSM Open , 9  (9)   pp. 1-5.    10.1177/2054270418793021 <https://doi.org/10.1177/2054270418793021>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10056808/1/Kinsella_Use%20of.pdf