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Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study.


ABSTRACT:

Background

The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg versus prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP).

Methods

Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study. A total of 513 pregnancies (52.89%) received no intervention. Concerning the remaining pregnancies, 151 (33.04%) pregnancies received an initial treatment of prednisone plus IVIg, 105 (22.98%) pregnancies received IVIg alone, and 172 (37.64%) pregnancies only received prednisone.

Results

Regarding the maternal response to the initial treatment, no differences were found among the three treatment groups (41.1% for prednisone plus IVIg, 33.1% for prednisone, and 38.1% for IVIg). However, a significant difference was observed in the time to response between the prednisone plus IVIg group (4.39 ± 2.54 days) and prednisone group (7.29 ± 5.01 days; p  < 0.001), and between the IVIg group (6.71 ± 4.85 days) and prednisone group (p < 0.001). The median prednisone duration in the monotherapy group was 27 days (range, 8-195 days), whereas that in the combination group was 14 days (range, 6-85 days). No significant differences were found among these three treatment groups in neonatal outcomes, particularly concerning the neonatal platelet counts. The time to response in the combination treatment group was shorter than prednisone monotherapy. The duration of prednisone application in combination group was shorter than prednisone monotherapy. The combined therapy showed a lower predelivery platelet transfusion rate than IVIg alone.

Conclusion

These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.

SUBMITTER: Zhu XL 

PROVIDER: S-EPMC9058461 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study.

Zhu Xiao-Lu XL   Feng Ru R   Huang Qiu-Sha QS   Liang Mei-Ying MY   Jiang Ming M   Liu Hui H   Liu Yi Y   Yao Hong-Xia HX   Zhang Lei L   Qian Shen-Xian SX   Yang Tong-Hua TH   Zhang Jing-Yu JY   Shen Xu-Liang XL   Yang Lin-Hua LH   Hu Jian-Da JD   Huang Ren-Wei RW   Jiang Zhong-Xing ZX   Wang Jing-Wen JW   Zhang Hong-Yu HY   Xiao Zhen Z   Zhan Si-Yan SY   Liu Hui-Xin HX   Wang Xing-Lin XL   Chang Ying-Jun YJ   Wang Yu Y   Kong Yuan Y   Xu Lan-Ping LP   Liu Kai-Yan KY   Zhang Xiao-Hong XH   Yin Cheng-Hong CH   Li Yue-Ying YY   Wang Qian-Fei QF   Wang Jian-Liu JL   Huang Xiao-Jun XJ   Zhang Xiao-Hui XH  

Therapeutic advances in hematology 20220429


<h4>Background</h4>The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg <i>versus</i> prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP).<h4>Methods</h4>Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study  ...[more]

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