Single dose of anti-D immune globulin at 75μg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children

Tarantino, Michael D.; Young, Guy; Bertolone, Salvatore; Kalinyak, Karen; Shafer, Frank; Kulkarni, Roshni; Weber, Lisa C.; Davis, M. L.; Lynn, Henry; Nugent, Diane J.

doi:10.1016/j.jpeds.2005.11.019

Cited by 101 publications

(76 citation statements)

References 30 publications

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“…Since 1996 there have been 3 randomized trials comparing therapy with anti-D and IVIg. [29][30][31] Two studies used a platelet count of Ͼ 20 ϫ 10 9 /L at 72 hours as the primary end point. These studies, using different doses of anti-D, reported contradictory results regarding its benefit over IVIg.…”

Section: 2a We Recommendmentioning

confidence: 99%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,650

1,783

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Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation, and presentation of the available evidence. We have endeavored to identify, abstract, and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality-interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP, and studies that will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first-line intervention. (Blood. 2011;117(16):4190-4207)

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Section: 2a We Recommendmentioning

confidence: 99%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,650

1,783

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show abstract

“…These findings indicate the similar effect of IVIG and anti-D in the treatment of acute ITP in children. Other studies have also reported similar findings (30,31). Although these drugs have different mechanisms of action (IVIG suppresses the Fc receptor and anti-D binds to host antigens), they both increase platelet survival eventually through blocking the RES (15).…”

Section: Discussionmentioning

confidence: 64%

“…Amongst the main issues, the treatment process of ITP is to increase the baseline platelet count to more than 20,000/mm 3 at a dose of 0.8 to 1 g/kg had similar effects in increasing the platelet count and that the required time to increase the platelet count to more than 20,000/mm 3 was similar for both drugs (30). Hemoglobin decrease in ITP patients is another issue that warrants attention in the treatment of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Different studies have reported decreased hemoglobin levels after IVIG and anti-D administration (4,18,19,32). The decrease may also be dose-related; the decrease has been reported to be 1.6, 2, and 0.3 g/dL in those receiving 50 µg/kg and 75 µg/kg of anti-D, and IVIG, respectively (30). However, lack of a marked difference in the decreased hemoglobin level between IVIG and anti-D indicates the similar effect of these drugs.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Therapeutic Effect of Anti-D IG and IVIG in Children with Acute Immune Thrombocytopenic Purpura Attending a Children’s Medical Center: A Randomized, Double-Blind, Controlled Clinical Trial

et al. 2017

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Background: This study aimed at comparing the therapeutic effect of anti-D immunoglobulin (anti-D IG) and Intravenous Immunoglobulin (IVIG) in children with acute immune thrombocytopenic purpura (ITP). Methods: This Randomized double-blind, controlled clinical trial was conducted on 98 children attending a Children's medical center during year 2008. The selected participants were allocated to IVIG and anti-D IG groups using the balanced-block randomization method. The platelet count, hemoglobin level, and side effects of the medications were evaluated on days 1, 3, 7, 14, and 21 after drug injection. Results: After drug injection, the platelet count increased in both groups (P < 0.001) yet there was no difference between the 2 groups (P > 0.05). The hemoglobin level also decreased after injection in both groups (P < 0.001) and the decrease was similar in both groups (P > 0.05). Regarding the ability of the drugs to increase the platelet count, 56% of the patients in the anti-D IG group and 52% of the children in the IVIG groups had platelet counts of more than 20 000 during the 24 hours after drug administration with no difference between the 2 groups (P = 0.836). The incidence of drug adverse effects, including fever and chills (4.1% in the anti-D group versus 10.4% in the IVIG group), severe hemolysis (4.5% in the anti D group versus 0% in the IVIG group) and headache (6.25% in the anti-D group versus 4.1% in the IVIG group), had no significant difference between the two groups (P > 0.05). Conclusions: Intravenous Immunoglobulin and anti-D have similar effectiveness in the treatment of children with acute ITP. Considering the fewer side effects of anti-D, it may be a suitable replacement for IVIG in ITP patients.

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“…Anti-D [53,54] 75 ug/kg per dose IV 1-3 d 3-7 d Rituximab [55,56,57] 375 mg/m2 per dose IV (4 weekly doses) [46] up to 2 mg/dose IV (4-6 weekly doses)…”

Section: -14 D 4-28 Dmentioning

confidence: 99%

A Case Report of Bernard-Soulier Syndrome in Differential Diagnosis of Immune Thrombocytopenic Purpura.

Wasfi¹,

ijar²

2018

IJAR

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Single dose of anti-D immune globulin at 75μg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children

Cited by 101 publications

References 30 publications

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Comparison of the Therapeutic Effect of Anti-D IG and IVIG in Children with Acute Immune Thrombocytopenic Purpura Attending a Children’s Medical Center: A Randomized, Double-Blind, Controlled Clinical Trial

A Case Report of Bernard-Soulier Syndrome in Differential Diagnosis of Immune Thrombocytopenic Purpura.

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