Praiseldy Langi Sasongko

108 Chapter 3 ficiencies and hematology). Furthermore, 6 experts described the increased demand in neurology, where the amount of CIDP and MMN patients are fewer but have higher consumption: “When it comes to number of patients, those with [primary] immune deficiencies is a high number. But if you look into usage of grams or kilograms of products, then the neuromuscular disorders (the MMN or CIDP) consume more. There are less patients, but the dosage is much higher.” (Expert 5) Moreover, the growth in neurology underlies another significant growth in the area of secondary immune deficiencies (SIDs). Five experts had noticed this trend with similar explanations surrounding patient numbers (“For 1 PID patient, you have 20 or 30 SIDs” (Expert 5)) and Ig’s efficacy in treating SIDs (“we learned from experience that Ig really works not only in PIDs but also in SIDs” (Expert 14). Table 3.1 Descriptives of interviewed experts Expert characteristics Number of Experts from total (n = 15) Gender Male 10 (67%) Female 5 (33%) Occupation Clinician-researcher 8 (53%) Hospital pharmacist 1 (7%) Patient organisation representative 1 (7%) Not-for-profit plasma association representative 1 (7%) Sanquin Plasma Products employees 3 (20%) Immunoglobulin scientist 1 (7%) Years of experience 0-10 1 (7%) 1-20 8 (53%) 21 and more 6 (40%) Clinical specialties represented Neurology, Nephrology, Dermatology, Immunology, Hematology, and Hematooncology II. Potential new areas of medical need for immunoglobulins With regards to potential new areas of medical need and new indications for Ig, the literature search provided more indications than the interviews. The literature provided a number of possible Ig treatment options in infectious diseases such as encephalitis,38,39 in solid organ transplant patients,40,41 in dermatology such as atopic dermatitis,42–45 in immunology and rheumatology, such as systemic lupus erythematosus,46–48 to treat sepsis,49–51 and in women with reproductive failure.52,53

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