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Patients who require treatment for immune thrombocytopenic purpura (ITP) often are given 1 mg/kg of prednisone daily. Most patients respond with increases in platelet count, but relapses are common when the dose is tapered. In this study from Hong Kong, researchers examined a different approach -- a short course of the high-dose corticosteroid dexamethasone. Dexamethasone is about 6 times as potent as prednisone and has a longer plasma and biologic half-life.
Researchers enrolled 125 (of 157) consecutive adults with newly diagnosed ITP who had either platelet counts lower than 20,000/mm3, or significant mucosal bleeding and platelet counts lower than 50,000/mm3. Patients were treated with oral dexamethasone (40 mg daily) for 4 days. An initi…