Risk Factors Associated With Thrombocytopenia Induced by Intravenous Immunoglobulin Formulations: An Analysis Using the JADER database.

Abstract

Background/aim: Thrombocytopenia is a serious adverse event observed with intravenous immunoglobulin formulations (IVIg). There have been some individual case reports of such events, but to our knowledge, no epidemiological studies have been reported. In this study, the risk of IVIg-induced thrombocytopenia and factors associated with IVIg-induced thrombocytopenia were examined using the Japanese Adverse Drug Event Report database.

Patients and methods: Data spanning from April 2004 to August 2024 were used. The association between IVIg and thrombocytopenia was evaluated using the reporting odds ratio (ROR). The reports of IVIg-induced thrombocytopenia events were evaluated by disease and aggregated by disease group. Factors associated with IVIg-induced thrombocytopenia were detected using multiple logistic regression with age, sex, formulation method, and disease group as explanatory variables and adjusted RORs were calculated.

Results: The IVIgs examined were significantly associated with thrombocytopenia. Pemphigoid was the most frequently reported disease, followed by Kawasaki disease and polymyositis/dermatomyositis. Immune-mediated skin diseases were the most frequently reported disease group, followed by Kawasaki disease, immune-mediated neurological diseases, and immune-mediated muscular diseases. Multiple logistic regression analysis showed that at age 60 years or older, immune-mediated skin diseases and immune-mediated muscular diseases were independently associated with significantly increased RORs.

Conclusion: This study suggests that IVIg can induce thrombocytopenia and that thrombocytopenia should be assessed in patients with immune-mediated skin diseases, immune-mediated muscular diseases and in the elderly.