The efficacy and safety of 2 cycles' high-dose dexamethasone treatment adult primary immune thrombocytopenia
10.3760/cma.j.issn.0578-1426.2011.05.011
- VernacularTitle:连续2个周期大剂量地塞米松治疗成人原发免疫性血小板减少症的疗效和安全性
- Author:
Zhongguang GUI
;
Yu WEI
;
Ming HOU
;
Hongguo ZHAO
;
Hongyi WANG
- Publication Type:Journal Article
- Keywords:
Dexamethasone;
Prednisone;
Treatment outcome;
Safety;
Primary immunethrombocytopenia
- From:
Chinese Journal of Internal Medicine
2011;50(5):401-403
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of a schedule of 2 cycles' high-dose dexamethasone (HD-DXM) as an initial therapy in adults immune thrombocytopenia (ITP), and compare with conventional dose prednisone therapy. Method A total of 59 newly diagnosed ITP patients were divided into 2 groups randomly. In 30 patients ( Dexamethasone group), oral HD-DXM was administered at 40 mg/d for 4 consecutive days, repeated one week later, and then failed to maintain. In the remaining 29and then gradually tapered. Results For short-term efficacy, after 1 and 2 weeks of treatment, the response rate in Dexamethasone group was significantly higher than that in Prednisone group (50. 0% vs 24. 1%, P ＜0. 01; 73.3% vs 55.2%, P ＜0. 05 ), while 3 weeks later, there was no remarkable difference between the two groups(83.3% vs 68.9%, P ＞ 0. 05 ), though the response rate in Dexamethasone group remained higher. For long-term effect, at the end of the 2nd and 3rd months of follow-up, the relapse rate in Dexamethasone group was significantly lower than that in Prednisone group(24. 0% vs 40. 0%, P ＜ 0. 05;32.0% vs 65. 0%, P ＜ 0. 01 ), while at the end of the 1st month of follow-up, there was no significant difference( 16. 0% vs 20. 0%, P ＞0.05 ). In addition, it's well tolerated and no complications such as severe infection or Cushing syndrome were complained in Dexamethasone group. Conclusion HD-DXM possesses an advantage over conventional dose prednisone therapy in efficacy and safety.
