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CC BY 4.0 · Glob Med Genet 2023; 10(02): 087-096
DOI: 10.1055/s-0043-1769087
Original Article

Efficacy and Safety Analysis of Combination Therapy Consisting of Intravenous Immunoglobulin and Corticosteroids versus Respective Monotherapies in the Treatment of Relapsed ITP in Adults

Lijun Fang
1   State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China
,
Jing Sun
2   Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
,
Yongqiang Zhao
3   Peking Union Medical College Hospital, Beijing, People's Republic of China
,
Ming Hou
4   Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
,
Depei Wu
5   The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
,
Yunfei Chen
1   State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China
,
Renchi Yang
1   State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China
,
Lei Zhang
1   State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China
6   Tianjin Institutes of Health Science, Tianjin, People's Republic of China
› Author Affiliations Funding This work was supported by grants from National Key Research and Development Program of China (2019YFA0110802), National Natural Science Foundation of China (Nos.82104618, 82270152, 8197012), CAMS Innovation Fund for Medical Sciences (CIFMS) (2022-I2M-2-003, 2020-I2M-C&T-B-086), and Haihe Laboratory of Cell Ecosystem Innovation Fund (22HHXBSS00022).
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Abstract

Objective In this study, we aimed to evaluate the efficacy and safety of combination therapy, consisting of intravenous immunoglobulin (IVIg) and corticosteroids, in comparison to respective monotherapies in the treatment of relapsed immune thrombocytopenia (ITP) in adults.

Methods A retrospective analysis of clinical data was conducted on 205 adult patients with relapsed ITP who received first-line combination therapy or monotherapy in multiple centers across China from January 2010 to December 2022. The study evaluated the patients' clinical characteristics, efficacy, and safety.

Results We found that the proportion of patients with platelet counts in complete response was significantly higher in the combination group (71.83%) compared with the IVIg group (43.48%) and the corticosteroids group (23.08%). The mean PLTmax in the combination group (178 × 109/L) was significantly higher than that in the IVIg group (109 × 109/L) and the corticosteroids group (76 × 109/L). Additionally, the average time for platelet counts to reach 30 × 109/L, 50 × 109/L, and 100 × 109/L in the combination group was significantly shorter than in the monotherapy groups. The proportion curves for reaching these platelet counts during treatment were also significantly different from those in the monotherapy groups. However, there were no significant differences in the effective rate, clinical characteristics, and adverse events among the three groups.

Conclusion We concluded that combining IVIg and corticosteroids was a more effective and faster treatment for relapsed ITP in adults than using either therapy alone. The findings of this study provided clinical evidence and reference for the use of first-line combination therapy in the treatment of relapsed ITP in adults.

Keywords

primary immune thrombocytopenia - adult relapse - first-line drugs - combination therapy


Publication History

Article published online:
23 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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