Alternatives for managing patients with newly diagnosed immune thrombocytopenia: a narrative review

First-line Therapy for Immune Thrombocytopenia: Time for Change

“…The combination of corticosteroids with rituximab led to a significant higher sustained response rate after 6 months as compared to corticosteroids alone (58%–76% versus 36%) 5 . This was true for both a classical drug dosing as for a low dose rituximab regimen.…”

“…6 The combination of corticosteroids with rituximab led to a significant higher sustained response rate after 6 months as compared to corticosteroids alone (58%-76% versus 36%). 5 This was true for both a classical drug dosing as for a low dose rituximab regimen. The superiority of the combination of rituximab and dexamethasone in maintaining a sustained response was confirmed in a meta-analysis (relative risk 0.57).…”

“…Current consensus and guidelines recommend corticosteroid monotherapy for first-line treatment of ITP, 3 although their long-term complete response (CR) rates only ranges between 20% and 50%. 4 , 5 With a therapy being only this moderately successful, it argues for strategies aiming at reaching for more sustained CRs. Indeed, several attempts have already been made in for first-line therapy in ITP, as nicely summarized recently by Gómez-Almaguer et al 5 …”

“… 4 , 5 With a therapy being only this moderately successful, it argues for strategies aiming at reaching for more sustained CRs. Indeed, several attempts have already been made in for first-line therapy in ITP, as nicely summarized recently by Gómez-Almaguer et al 5 …”

“…4,5 With a therapy being only this moderately successful, it argues for strategies aiming at reaching for more sustained CRs. Indeed, several attempts have already been made in for first-line therapy in ITP, as nicely summarized recently by Gómez-Almaguer et al 5 The first issue is the kind of steroid that is used. A recent meta-analysis showed that dexamethasone has equal overall response rates as prednisone, but is superior in sustained response rates after 12 months (relative risk 1.34) without changing adverse event rates.…”