Effect of Low-Dose Prednisolone Durations on Loss of Response Rates in Patients with Immune Thrombocytopenia

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Thanongsak Suwannathen
Fareeda Pleebut

Abstract

Background and Objective: Currently, the standard first-line treatment for patients with immune thrombocytopenia (ITP) patients is corticosteroids. Although most patients are responses to treatment, two-thirds of patients relapse or loss of response after discontinuing medication. The objective of this study was to evaluate the association between low-dose prednisolone durations (≤10 mg/day) and event (loss of response or relapse) rates in ITP patients.


Methods: The retrospective cohort study collected data from medical records of patients diagnosed ITP, treated at Khon Kaen Hospital from October 31st, 2011 to November 1st, 2020. The data were analyzed using Kaplan-Meier curve to analyze survival, Cox regression and log-rank test to compare between groups.


Results: One hundred and eighteen ITP patients were included, 78% were female, 82% were newly diagnosed ITP, mean age was 47.4 ± 17.5 years, 78.8% reached complete response after initial treatment. Median event-free survival after started low-dose prednisolone (LDP) in patients received LDP duration ≤6 months compare with LDP duration >6 months was 7.2 months (95%CI, 5.0 – 22.8) and 34.4 months (95%CI, 17.8 – 79.5), respectively, with hazard ratio 2.24 (95%CI, 1.39 – 3.65). Adverse effects from corticosteroids therapy in this study were not statistically significant differences between the two groups of patients.


Conclusions: Low-dose prednisolone treatment duration no more than 6 months was associated with higher rates of relapse or loss of response in ITP patients.

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1.
Suwannathen T, Pleebut F. Effect of Low-Dose Prednisolone Durations on Loss of Response Rates in Patients with Immune Thrombocytopenia. SRIMEDJ [Internet]. 2022 Aug. 30 [cited 2023 Feb. 7];37(4):346-53. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/254639
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