Identification factors to adjust early combination regimens in adult primary immune thrombocytopenia: An 8-year data analysis

dc.contributor.authorIam-arunthai K.
dc.contributor.authorChamnanchanunt S.
dc.contributor.authorThungthong P.
dc.contributor.authorNakhahes C.
dc.contributor.authorSuwanban T.
dc.contributor.authorRojnuckarin P.
dc.contributor.correspondenceIam-arunthai K.
dc.contributor.otherMahidol University
dc.date.accessioned2025-03-19T18:09:44Z
dc.date.available2025-03-19T18:09:44Z
dc.date.issued2023-01-01
dc.description.abstractPurpose: Recent studies suggested that adding other agents to corticosteroids as a first-line treatment for immune thrombocytopenia (ITP) could improve outcomes. However, combination regimens may increase side effects and costs. To determine clinical factors associated with responses to the first-line steroid at 1 month. Materials and methods: We retrospectively reviewed the medical records of patients with ITP aged ≥ 18 years, who were treated at Rajavithi Hospital between 2012 and 2020. Clinical data, laboratory results, treatment regimens, and responses to therapy were analyzed. Results: Of the 226 patients, 76.6% were female. The mean age was 46.5 ± 18.1 years, and the median follow-up duration was 40 months. The proportion of chronic ITP was 97.3%. The complete response and response rates to first-line therapy were 65.5% and 88.9%, respectively. The age over 26 years, presentation clinically non-significant bleeding and a difference in platelet count of >50 x 109/L between days 1 and 7 after initial treatment were associated with the response to first-line treatment (adjusted odds ratio [OR] 5.09, 95% confidence interval [CI] 1.50-17.28, p = 0.009); OR 5.87, 95%CI 1.19-28.91, p = 0.029, and OR 3.60, 95%CI 1.10-11.73, p = 0.034, respectively. Younger patients and a difference in platelet count between day 1 and 7 ≤ 50 x 109/L were more likely to require second-line treatments. There were significant increases in the median platelet counts after prescribing azathioprine (baseline vs. 3 months, p = 0.001), cyclophosphamide (baseline vs. 6 months, p = 0.021), or danazol (baseline vs. 12 months, p = 0.039). Conclusion: Adult, severity of bleeding at presentation, and rapid platelet increases within 1 week were related to excellent corticosteroid responses in ITP patients. These patients may not need combination regimens.
dc.identifier.citationFrontiers in Hematology Vol.2 (2023)
dc.identifier.doi10.3389/frhem.2023.1135261
dc.identifier.eissn28133935
dc.identifier.scopus2-s2.0-86000099649
dc.identifier.urihttps://repository.li.mahidol.ac.th/handle/20.500.14594/106713
dc.rights.holderSCOPUS
dc.subjectMedicine
dc.titleIdentification factors to adjust early combination regimens in adult primary immune thrombocytopenia: An 8-year data analysis
dc.typeArticle
mu.datasource.scopushttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=86000099649&origin=inward
oaire.citation.titleFrontiers in Hematology
oaire.citation.volume2
oairecerif.author.affiliationFaculty of Tropical Medicine, Mahidol University
oairecerif.author.affiliationRangsit University
oairecerif.author.affiliationFaculty of Medicine, Chulalongkorn University

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