Abstract
A proportion of patients with immune thrombocytopenic purpura are refractory to multiple therapies including thrombopoietin-receptor agonists (TPO-RA). We report 10 patients who did not respond to a TPO-RA until the addition of a glucocorticoid. These patients were previously treated with a median of 6 therapies. One patient elected to discontinue both medications despite persistent thrombocytopenia. The remaining 9 patients continued on the combination of prednisone (doses 5 mg every other day to 10 mg daily) and a TPO-RA. Combination therapy with low dose glucocorticoid and a TPO-RA may be an option for patients unresponsive to a TPO-RA alone.
Keywords:
Autoimmune thrombocytopenia; Glucocorticoids; Immune thrombocytopenic purpura; Refractory; Thrombopoietin-receptor agonists.
MeSH terms
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Adolescent
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Adult
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Aged
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Benzoates / administration & dosage
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Benzoates / adverse effects
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Benzoates / pharmacology
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Benzoates / therapeutic use*
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Child, Preschool
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Combined Modality Therapy
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Drug Synergism
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Drug Therapy, Combination
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Female
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Humans
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Hydrazines / administration & dosage
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Hydrazines / adverse effects
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Hydrazines / pharmacology
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Hydrazines / therapeutic use*
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Male
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Middle Aged
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Platelet Count
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Prednisone / pharmacology
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Prednisone / therapeutic use*
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Purpura, Thrombocytopenic, Idiopathic / drug therapy*
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Purpura, Thrombocytopenic, Idiopathic / surgery
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Pyrazoles / administration & dosage
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Pyrazoles / adverse effects
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Pyrazoles / pharmacology
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Pyrazoles / therapeutic use*
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Receptors, Fc / administration & dosage
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Receptors, Fc / therapeutic use*
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Receptors, Thrombopoietin / antagonists & inhibitors*
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Recombinant Fusion Proteins / administration & dosage
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Recombinant Fusion Proteins / adverse effects
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Recombinant Fusion Proteins / pharmacology
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Recombinant Fusion Proteins / therapeutic use*
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Splenectomy
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Thrombopoietin / administration & dosage
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Thrombopoietin / adverse effects
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Thrombopoietin / pharmacology
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Thrombopoietin / therapeutic use*
Substances
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Benzoates
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Hydrazines
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Pyrazoles
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Receptors, Fc
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Receptors, Thrombopoietin
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Recombinant Fusion Proteins
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MPL protein, human
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Thrombopoietin
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romiplostim
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eltrombopag
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Prednisone