Abstract Details

Title Is Intravenous Immunoglobulin Is More Cost Effective Than Plasmapheresis in the Treatment of Pediatric Myasthenia Gravis. Data from Kids' Inpatient Database (KID) 1997-2009

Topic Child Neurology/Developmental Neurobiology

Presentation(s) P03 - (-)

Poster/Presentation
Number 004

Objective

Background BACKGROUND: Both IVIg and plasmapheresis have been extensively used in treatment of moderate to severe MG. As per AAN guidelines IVIg is probably effective (Level B), while there is insufficient evidence to support the use of plasmapheresis for MG (Level U).

Design/Methods DESIGN/METHODS: We analyzed the Kid's Inpatient Database (KID) for age, length of stay, and hospitalization cost for pediatric patients hospitalized with MG between 1997 and 2009. We compared these variables when patients were treated with IVIg versus plasmapheresis.

Results RESULTS: Among 30, 49, 45, 78, 128 pediatric patients admitted to hospitals for MG on 1997, 2000, 2003, 2006, 2009 respectively, 5/25, 12/37, 24/21, 36/42, 76/52 were treated with IVIg/ plasmapheresis respectively. The average age of patients treated with IVIg was significantly lower than the average age of patients treated with plasmapheresis from 1997 to 2006. The mean length of stay was significantly longer in patients treated with plasmapheresis except for the year 2003: for IVIG patients the average length of stay varied between 2.63 and 7.2 days, whereas for plasmapheresis, it varied between 6.73 and 10.38 days. The vast majority of patients were discharged to home in all studied time periods. The mean hospitalization charges was higher in the plasmapheresis group compared to IVIG group in all time periods, however it reached statistical significance on 2003. It varied from $ 37,426 in 1997 and $90,619 in 2009 in the plasmapheresis group. In the IVIg group the mean hospitalization charges varied between $18,960 in 1997 and $ 77,299 in 2009.

Conclusions CONCLUSIONS: The mean hospitalization charges and length of stay of pediatric patients with MG treated with plasmapheresis were higher than in group treated with IVIg from 1997 to 2009.

Authors/Disclosures
Rania A. Elenein, MD (Jefferson Health NJ) PRESENTER	Dr. Elenein has nothing to disclose.
Wenzhuan He, MD (UPMC Susquehanna Neurology)	Dr. He has nothing to disclose.
Nizar Souayah, MD, FAAN (NJMS)	Dr. Souayah has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Dr. Souayah has received publishing royalties from a publication relating to health care.
	No disclosure on file

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