Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia
Yıl: 2022 Cilt: 47 Sayı: 2 Sayfa Aralığı: 715 - 721 Metin Dili: İngilizce DOI: 10.17826/cumj.1085840 İndeks Tarihi: 29-07-2022
Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia
Öz: Purpose: We aimed to compare the efficacy of high-dose
methylprednisolone (HDP) with intravenous
immunoglobulin (IVIG) and conventional prednisolone
(CDP) as a first-line therapy in adult patients with immune
thrombocytopenia (ITP).
Materials and Methods: This retrospective study
included 140 adult patients with either previously
untreated newly diagnosed ITP (n=51) or persistent or
chronic ITP (n=22/n=67)) with episodes. Patients with a
platelet count <30x109/L or <50x109/L with a clinically
significant bleeding were treated either by CDP therapy
(1mg/kg/d until response) or HDP (20 mg/kg/d for 3 d)
or IVIG (1g/kg/d for 2 d). The patients in all groups
continued treatment with oral prednisolone (1 mg/kg/d)
until their platelet counts stabilized. After therapy, patients’
responses and clinical courses were evaluated.
Results: The initial platelet counts were similar in all
groups. HDP was given to 92 patients (65.7%), IVIG to
32 (22.8%), and CDP to 16 (11.4%). Although the HDP
group showed a first response sooner than the IVIG and
CDP groups, the median platelet count at first response
was similar in all groups. Long-term remission was greater
in the HDP group (57.6%) than in the IVIG (37.5%) and
CDP (25.0%) groups, and their respective recurrence rates
were 62.8%, 81.3% and 88.9%.
Conclusion: Our results indicate that HDP’s relative
effectiveness, low cost, and convenience of use continue
to recommend it as a first-line therapy for adult patients
with ITP.
Anahtar Kelime: İmmün trombositopenili erişkin hastalarda birinci basamak tedavide yüksek doz metilprednizolonun etkinliği
Öz: Amaç: İmmün trombositopenili (İTP) erişkin hastalarda
birinci basamak tedavi olarak yüksek doz metilprednizolon
(HDP) ile intravenöz immünoglobulin (İVİG) ve
konvansiyonel prednizolonun (CDP) etkinliğini
karşılaştırmayı amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışma, daha önce
tedavi edilmemiş yeni tanı konmuş İTP (n=51) veya
epizodları olan kalıcı (n=22) ya da kronik İTP (n=67)’li 140
yetişkin hastayı içermektedir. Trombosit sayısı <30x109/L
veya <50x109/L olan ve klinik olarak anlamlı kanaması
olan hastalar ya CDP tedavisi (yanıta kadar 1 mg/kg/gün)
ya da HDP (3 gün boyunca 20 mg/kg/gün) ya da İVİG (2
gün boyunca 1g/kg/gün) ile tedavi edilmiştir. Tüm
gruplardaki hastalar trombosit sayıları stabilize olana kadar
oral prednizolon (1 mg/kg/gün) ile tedaviye devam etti.
Tedaviden sonra hastaların yanıtları ve klinik seyirleri
değerlendirildi.
Bulgular: Başlangıç trombosit sayıları tüm gruplarda
benzerdi. 92'sine (%65.7) HDP, 32'sine (%22.8) İVİG ve
16'sına (%11.4) CDP verildi. HDP grubu, İVİG ve CDP
gruplarından daha erken ilk yanıt gösterse de, ilk yanıttaki
medyan trombosit sayısı tüm gruplarda benzerdi. HDP
grubunda (%57.6), İVİG (%37.5) ve CDP (%25.0)
gruplarına göre uzun süreli remisyon daha yüksekti ve
bunların nüks oranları sırasıyla %62.8, %81.3 ve %88.9 idi.
Sonuç: Sonuçlar, HDP'nin göreceli etkinliği, düşük
maliyeti ve kullanım kolaylığının, onu İTP'li yetişkin
hastalar için birinci basamak tedavi olarak önermeye
devam ettiğini göstermektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | AYDIN K, GURKAN E (2022). Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. , 715 - 721. 10.17826/cumj.1085840 |
| Chicago | AYDIN Kaniye,GURKAN EMEL Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. (2022): 715 - 721. 10.17826/cumj.1085840 |
| MLA | AYDIN Kaniye,GURKAN EMEL Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. , 2022, ss.715 - 721. 10.17826/cumj.1085840 |
| AMA | AYDIN K,GURKAN E Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. . 2022; 715 - 721. 10.17826/cumj.1085840 |
| Vancouver | AYDIN K,GURKAN E Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. . 2022; 715 - 721. 10.17826/cumj.1085840 |
| IEEE | AYDIN K,GURKAN E "Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia." , ss.715 - 721, 2022. 10.17826/cumj.1085840 |
| ISNAD | AYDIN, Kaniye - GURKAN, EMEL. "Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia". (2022), 715-721. https://doi.org/10.17826/cumj.1085840 |
| APA | AYDIN K, GURKAN E (2022). Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. Cukurova Medical Journal, 47(2), 715 - 721. 10.17826/cumj.1085840 |
| Chicago | AYDIN Kaniye,GURKAN EMEL Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. Cukurova Medical Journal 47, no.2 (2022): 715 - 721. 10.17826/cumj.1085840 |
| MLA | AYDIN Kaniye,GURKAN EMEL Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. Cukurova Medical Journal, vol.47, no.2, 2022, ss.715 - 721. 10.17826/cumj.1085840 |
| AMA | AYDIN K,GURKAN E Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. Cukurova Medical Journal. 2022; 47(2): 715 - 721. 10.17826/cumj.1085840 |
| Vancouver | AYDIN K,GURKAN E Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia. Cukurova Medical Journal. 2022; 47(2): 715 - 721. 10.17826/cumj.1085840 |
| IEEE | AYDIN K,GURKAN E "Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia." Cukurova Medical Journal, 47, ss.715 - 721, 2022. 10.17826/cumj.1085840 |
| ISNAD | AYDIN, Kaniye - GURKAN, EMEL. "Efficacy of high-dose methylprednisolone as a first-line therapy in adult patients with immune thrombocytopenia". Cukurova Medical Journal 47/2 (2022), 715-721. https://doi.org/10.17826/cumj.1085840 |
