[Challenges and potential solutions in first-line treatments for immune thrombocytopenia in adults].
Traitements de première ligne au cours du purpura thrombopénique immunologique de l'adulte : état des lieux et perspectives.
Dexamethasone
Dexaméthasone
Immune thrombocytopenic purpura
Immunoglobulines intraveineuses
Intravenous immunoglobulins
Prednisone
Purpura thrombopénique immunologique
Journal
La Revue de medecine interne
ISSN: 1768-3122
Titre abrégé: Rev Med Interne
Pays: France
ID NLM: 8101383
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
05
03
2020
revised:
04
06
2020
accepted:
20
06
2020
pubmed:
28
7
2020
medline:
25
11
2021
entrez:
28
7
2020
Statut:
ppublish
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 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.
Identifiants
pubmed: 32713675
pii: S0248-8663(20)30244-7
doi: 10.1016/j.revmed.2020.06.018
pii:
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Immunoglobulins, Intravenous
0
Types de publication
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
25-31Informations de copyright
Copyright © 2020. Published by Elsevier Masson SAS.