[Challenges and potential solutions in first-line treatments for immune thrombocytopenia in adults].
Fiche publication
Date publication
juillet 2020
Journal
La Revue de medecine interne
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BONNOTTE Bernard
Tous les auteurs :
Godeau B, Bonnotte B, Michel M
Lien Pubmed
Résumé
The first line treatment of immune thrombocytopenic purpura (ITP) is well established and based on short course of corticosteroids associated with intravenous immunoglobulins (IVIg) for the most severe forms. Predniso(lo)ne is the corticosteroid agent usually given but dexamethasone appears as an alternative. Some guidelines recommend to use dexamethasone as first line when a rapid increase of platelet count is required. Dexamethasone could be used rather than IVIg except for moderate to severe but non life-threatening bleeding manifestations. Other therapeutic options such as anti FcRn monoclonal antibodies or recombinant FcγR currently in development for ITP could be an option in the future. In newly diagnosed ITP, we unfortunately lack robust predictive risk factors of severity and chronic outcome. Identifying such factors could be helpful for considering the early use of some treatments which are commonly used as second or third line.
Mots clés
Dexamethasone, Dexaméthasone, Immune thrombocytopenic purpura, Immunoglobulines intraveineuses, Intravenous immunoglobulins, Prednisone, Purpura thrombopénique immunologique
Référence
Rev Med Interne. 2020 Jul 24;: