High-dose dexamethasone therapy as the initial treatment for idiopathic thrombocytopenic purpura

被引：8
|
作者：
Takase, Ken [1 ]
Nagai, Hirokazu [2 ]
Kadono, Moe [3 ]
Yoshioka, Takanori [4 ]
Yoshio, Nobuyuki [5 ]
Hirabayashi, Yukio [6 ]
Ito, Takuo [7 ]
Sawamura, Morio [8 ]
Yokoyama, Akihiro [9 ]
Yoshida, Shinichiro [10 ]
Tsutsumi, Ikuyo [11 ]
Otsuka, Maki [12 ]
Suehiro, Youko [13 ]
Hidaka, Michihiro [14 ]
Yoshida, Isao [15 ]
Yokoyama, Hisayuki [16 ]
Inoue, Hitoshi [17 ]
Iida, Hiroatsu [2 ]
Nakayama, Maki [18 ]
Hishita, Terutoshi [19 ]
Iwasaki, Hiromi [1 ]
Kada, Akiko [20 ]
Saito, Akiko M. [20 ]
Kuroda, Yoshiaki [3 ]
机构：
[1] Natl Hosp Org Kyushu Med Ctr, Dept Hematol, Chuo Ku, 1-8-1 Jigyohama, Fukuoka, Fukuoka 8108563, Japan
[2] Natl Hosp Org Nagoya Med Ctr, Dept Hematol, Nagoya, Aichi, Japan
[3] Natl Hosp Org Hiroshimanishi Med Ctr, Dept Hematol, Otake, Japan
[4] Natl Hosp Org Okayama Med Ctr, Dept Hematol, Okayama, Japan
[5] Natl Hosp Org Kanazawa Med Ctr, Dept Hematol, Kanazawa, Ishikawa, Japan
[6] Natl Hosp Org Matsumoto Med Ctr, Matsumoto Hosp, Dept Hematol, Matsumoto, Nagano, Japan
[7] Natl Hosp Org Kure Med Ctr & Chugoku Canc Ctr, Dept Hematol, Kure, Hiroshima, Japan
[8] Natl Hosp Org Shibukawa Med Ctr, Dept Clin Res, Shibukawa, Gunma, Japan
[9] Natl Hosp Org Tokyo Med Ctr, Dept Internal Med, Div Transfus Med, Div Hematol, Tokyo, Japan
[10] Natl Hosp Org Nagasaki Med Ctr, Dept Hematol, Nagasaki, Japan
[11] Natl Hosp Org Mito Med Ctr, Dept Hematol, Ibaraki, Japan
[12] Natl Hosp Org Kagoshima Med Ctr, Dept Hematol, Kagoshima, Japan
[13] Natl Hosp Org Kyushu Canc Ctr, Dept Hematol, Fukuoka, Fukuoka, Japan
[14] Natl Hosp Org Kumamoto Med Ctr, Dept Hematol, Kumamoto, Japan
[15] Natl Hosp Org Shikoku Canc Ctr, Dept Hematol & Oncol, Matsuyama, Ehime, Japan
[16] Natl Hosp Org Sendai Med Ctr, Dept Hematol, Sendai, Miyagi, Japan
[17] Natl Hosp Org Tsuruga Med Ctr, Dept Internal Med, Tsuruga, Fukui, Japan
[18] Natl Hosp Org Nishibeppu Natl Hosp, Dept Hematol, Beppu, Oita, Japan
[19] Natl Hosp Org Himeji Med Ctr, Dept Hematol, Himeji, Hyogo, Japan
[20] Natl Hosp Org Nagoya Med Ctr, Clin Res Ctr, Nagoya, Aichi, Japan
来源：
INTERNATIONAL JOURNAL OF HEMATOLOGY | 2020年 / 111卷 / 03期
关键词：
Idiopathic thrombocytopenic purpura; Short-term; High-dose dexamethasone therapy; Open-label; Single-arm trial; HELICOBACTER-PYLORI ERADICATION; IMMUNE THROMBOCYTOPENIA; MULTICENTER; ADULTS; PREDNISONE; CRITERIA; CHILDREN;
D O I：
10.1007/s12185-019-02808-6
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
There is a controversy which short term high dose dexamethasone therapy (HDD) or standard dose prednisolone therapy as the initial treatment leads to long term efficacy in idiopathic thrombocytopenic purpura (ITP) patients. We conducted a multicenter, prospective trial to determine the efficacy and safety of short-term HDD in ITP patients aged 18-80 years with platelet counts of < 20 x 10(9)/l, or < 50 x 10(9)/l and bleeding symptoms. The primary endpoints are the proportion of complete response (CR) plus partial response (R) on day 180 after the completion of the 46-day HDD. Twenty-three patients were enrolled. Test for Helicobacter pylori (H. pylori) was positive for 6 patients and negative for 17 patients. In positive patients, 5 were received successful H. pylori eradication therapy. The proportion of CR + R was 60.9% (14/23) with 90% confidence interval of 41.7-77.8%. For patients with positive H. pylori and successful eradication, the proportion of CR + R was 80.0% (4/5). There was one grade 4 adverse event. Although we have enrolled relatively old, severe ITP patients with a median age of 63 years in this study, the efficacy was comparable to the reported clinical trials with HDD therapy.
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页码：388 / 395
页数：8
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