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Methylprednisolone versus intravenous immune globulin as an initial therapy in adult primary immune thrombocytopenia.


ABSTRACT:

Background/aims

Few studies have addressed whether there are differences in clinical efficacy between intravenous methylprednisolone (methyl-Pd) and intravenous immunoglobulin (IVIg) use.

Methods

We retrospectively compared platelet responses and toxicities associated with these two treatments in adult patients with immune thrombocytopenia. Patients received intravenous methyl-Pd therapy followed by oral prednisolone (Pd) from 1993 to 2002 and IVIg together with oral Pd from 2003 to 2008.

Results

Early response and maintenance of the response were assessed at 7 days and 6 months after treatment, respectively. Of the 87 patients enrolled, 77 (88.5%) were eligible for analysis. Early responses occurred in 30 of 39 patients (76.9%) receiving methyl-Pd versus 33 of 38 patients (86.6%) receiving IVIg (p = 0.187). The response was maintained in 28 patients (71.8%) in the methyl-Pd arm and in 23 patients (60.5%) in the IVIg arm (p = 0.187). The time to a complete response in the IVIg arm (6 days; range, 1 to 35) was shorter than that in the methyl-Pd arm (13.5 days; range, 2 to 29) (p = 0.002). Side effects were mild and tolerable in both arms. Five years after initiating treatment, 7 of 18 patients (38.9%) and five of 14 patients (35.7%) were still maintaining a response in the methyl-Pd and IVIg arms, respectively.

Conclusion

These results indicate that neither the early response rate nor the long-term outcome differed between the methyl-Pd and IVIg treatments. However, IVIg induced a complete response more rapidly than did methyl-Pd.

SUBMITTER: Kim CH 

PROVIDER: S-EPMC6406098 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Methylprednisolone versus intravenous immune globulin as an initial therapy in adult primary immune thrombocytopenia.

Kim Chul Hee CH   Choi Yoon Seok YS   Moon Ji Young JY   Kim Duck Yong DY   Lee So Yeon SY   Lee Hyo Jin HJ   Yun Hwan Jung HJ   Kim Samyong S   Jo Deog Yeon DY   Song Ik Chan IC  

The Korean journal of internal medicine 20171127 2


<h4>Background/aims</h4>Few studies have addressed whether there are differences in clinical efficacy between intravenous methylprednisolone (methyl-Pd) and intravenous immunoglobulin (IVIg) use.<h4>Methods</h4>We retrospectively compared platelet responses and toxicities associated with these two treatments in adult patients with immune thrombocytopenia. Patients received intravenous methyl-Pd therapy followed by oral prednisolone (Pd) from 1993 to 2002 and IVIg together with oral Pd from 2003  ...[more]

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