Treatment of Primary ITP in Adults
- First-line or upfront therapy for idiopathic thrombocytopenic purpura
- Corticosteroids:
- Prednisone (0.5-2 mg/kg/day) is commonly used as the initial therapy Used with tapering based on response
- Dexamethasone (40 mg PO daily x 4 days for 1-3 cycles)
- Overall response:54 %vs 43% (P=.44)
- Adverse event rates:
- High-dose dexamethasone:24%
- Standard-dose prednisone:46%
- Frontline Rituximab in ITP
- Intravenous immunoglobulin used at 0.8-1.0 g/kg for 1 dose:
- Consider use for patients needing rapid platelet increase (eg, those with active bleeding) or those who cannot tolerate steroids
- Anti-D immunoglobulin used at 50-75 μg/kg IV for 1 dose
- Second-line or maintainence therapy for idiopathic thrombocytopenic purpura
- Chronic or refractory for idiopathic thrombocytopenic purpura
- Bleeding Treatment for idiopathic thrombocytopenic purpura