Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study.

immune thrombocytopenia intravenous immunoglobulin prednisone pregnant

Journal

Therapeutic advances in hematology
ISSN: 2040-6207
Titre abrégé: Ther Adv Hematol
Pays: England
ID NLM: 101549589

Informations de publication

Date de publication:
2022
Historique:
received: 04 12 2021
accepted: 16 03 2022
entrez: 5 5 2022
pubmed: 6 5 2022
medline: 6 5 2022
Statut: epublish

Résumé

The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study. A total of 513 pregnancies (52.89%) received no intervention. Concerning the remaining pregnancies, 151 (33.04%) pregnancies received an initial treatment of prednisone plus IVIg, 105 (22.98%) pregnancies received IVIg alone, and 172 (37.64%) pregnancies only received prednisone. Regarding the maternal response to the initial treatment, no differences were found among the three treatment groups (41.1% for prednisone plus IVIg, 33.1% for prednisone, and 38.1% for IVIg). However, a significant difference was observed in the time to response between the prednisone plus IVIg group (4.39 ± 2.54 days) and prednisone group (7.29 ± 5.01 days; These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.

Sections du résumé

Background UNASSIGNED
The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg
Methods UNASSIGNED
Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study. A total of 513 pregnancies (52.89%) received no intervention. Concerning the remaining pregnancies, 151 (33.04%) pregnancies received an initial treatment of prednisone plus IVIg, 105 (22.98%) pregnancies received IVIg alone, and 172 (37.64%) pregnancies only received prednisone.
Results UNASSIGNED
Regarding the maternal response to the initial treatment, no differences were found among the three treatment groups (41.1% for prednisone plus IVIg, 33.1% for prednisone, and 38.1% for IVIg). However, a significant difference was observed in the time to response between the prednisone plus IVIg group (4.39 ± 2.54 days) and prednisone group (7.29 ± 5.01 days;
Conclusion UNASSIGNED
These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.

Identifiants

DOI: 10.1177/20406207221095226 PMID: 35510211 PMC: PMC9058461
pubmed: 35510211
doi: 10.1177/20406207221095226
pii: 10.1177_20406207221095226
pmc: PMC9058461
doi:

Types de publication

Journal Article

Langues

eng

Pagination

20406207221095226

Informations de copyright

© The Author(s), 2022.

Déclaration de conflit d'intérêts

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Références

Blood. 2017 Aug 31;130(9):1097-1103
pubmed: 28630121
Blood. 2011 Apr 21;117(16):4190-207
pubmed: 21325604
Semin Thromb Hemost. 2011 Sep;37(6):631-9
pubmed: 22102266
Blood. 2003 Dec 15;102(13):4306-11
pubmed: 12947011
Am J Hematol. 2021 May 1;96(5):561-570
pubmed: 33606900
Blood Adv. 2019 Nov 26;3(22):3780-3817
pubmed: 31770441
Anaesthesia. 2016 Jun;71(6):648-56
pubmed: 27062151
Blood Res. 2014 Dec;49(4):259-64
pubmed: 25548760
Blood Coagul Fibrinolysis. 2020 Dec;31(8):517-521
pubmed: 32897892
Blood. 2011 Feb 3;117(5):1499-506
pubmed: 21098742
J Obstet Gynaecol Can. 2009 Oct;31(10):980-993
pubmed: 19941729
Br J Haematol. 2014 Sep;166(6):929-35
pubmed: 24957165
Blood Adv. 2019 Dec 10;3(23):3829-3866
pubmed: 31794604
J Allergy Clin Immunol. 2017 Mar;139(3S):S1-S46
pubmed: 28041678
Zhonghua Xue Ye Xue Za Zhi. 2020 Aug 14;41(8):617-623
pubmed: 32942813
Br J Haematol. 2003 Feb;120(4):574-96
pubmed: 12588344
Lancet. 2007 Oct 20;370(9596):1453-7
pubmed: 18064739
Am J Obstet Gynecol. 1996 May;174(5):1414-23
pubmed: 9065105
Semin Hematol. 2000 Jul;37(3):275-89
pubmed: 10942222
Front Immunol. 2018 Jun 08;9:1299
pubmed: 29951056
Blood. 2017 Nov 23;130(21):2271-2277
pubmed: 28637667
Int J Hematol. 2014 Dec;100(6):540-4
pubmed: 25293555
Blood. 2010 Jan 14;115(2):168-86
pubmed: 19846889
BJOG. 2018 Apr;125(5):604-612
pubmed: 28432736
Arthritis Rheum. 2012 Aug;64(8):2677-86
pubmed: 22553077
Blood. 2009 Mar 12;113(11):2386-93
pubmed: 19005182
Teratology. 2000 Dec;62(6):385-92
pubmed: 11091360
J Perinat Med. 2006;34(4):280-4
pubmed: 16856815
Br J Haematol. 1996 Oct;95(1):21-6
pubmed: 8857933
Blood Rev. 2002 Mar;16(1):43-6
pubmed: 11913994
N Engl J Med. 1997 Jul 17;337(3):148-53
pubmed: 9219700
Ther Adv Hematol. 2021 Mar 19;12:20406207211001139
pubmed: 33796239
Blood Rev. 2020 Mar;40:100638
pubmed: 31757523
Transfus Med Rev. 2018 Oct;32(4):225-229
pubmed: 30177431
Blood. 2016 Sep 8;128(10):1329-35
pubmed: 27402971
Br J Haematol. 2012 Apr;157(1):47-58
pubmed: 22313321
Am J Reprod Immunol. 2018 Oct;80(4):e13000
pubmed: 30010227
Br J Obstet Gynaecol. 1990 Oct;97(10):893-8
pubmed: 2223679
Blood. 2020 Dec 24;136(26):3056-3061
pubmed: 32814348
Blood. 2013 Jan 3;121(1):38-47
pubmed: 23149846
J Obstet Gynaecol Res. 2015 Jan;41(1):44-9
pubmed: 25163390
Front Immunol. 2020 Jan 22;10:3017
pubmed: 32038609
Clin Exp Med. 2019 Nov;19(4):495-503
pubmed: 31463831
Acta Obstet Gynecol Scand. 2000 Sep;79(9):744-9
pubmed: 10993097
Korean J Intern Med. 2005 Jun;20(2):129-34
pubmed: 16134767
Ann Hematol. 2006 Aug;85(8):552-4
pubmed: 16710716
N Engl J Med. 2002 Mar 28;346(13):995-1008
pubmed: 11919310
J Matern Fetal Neonatal Med. 2009 Nov;22(11):1081-5
pubmed: 19900049
Platelets. 2020;31(3):300-306
pubmed: 31296105
Int J Hematol. 2002 May;75(4):426-33
pubmed: 12041677
Medicine (Baltimore). 2017 Jul;96(29):e7561
pubmed: 28723784
Transfus Med Rev. 2013 Jul;27(3):171-8
pubmed: 23835249
Platelets. 2020;31(3):403-406
pubmed: 31116059

Auteurs

Xiao-Lu Zhu (XL)

Peking University People's Hospital, Beijing, P.R. China.

Ru Feng (R)

Departments of Hematology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.

Qiu-Sha Huang (QS)

Peking University People's Hospital, Beijing, P.R. China.

Mei-Ying Liang (MY)

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, P.R. China.

Ming Jiang (M)

Center of Hematologic Diseases, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, P.R. China.

Hui Liu (H)

Departments of Hematology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.

Yi Liu (Y)

Department of Hematology, Navy General Hospital, Beijing, P.R. China.

Hong-Xia Yao (HX)

Department of Hematology, People's Hospital of Hainan Province, Haikou, P.R. China.

Lei Zhang (L)

State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.

Shen-Xian Qian (SX)

Department of Hematology, First People's Hospital of Hangzhou, Hangzhou, P.R. China.

Tong-Hua Yang (TH)

Department of Hematology, First People's Hospital of Yunnan Province, Kunming, P.R. China.

Jing-Yu Zhang (JY)

Department of Hematology, Hebei Institute of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, P.R. China.

Xu-Liang Shen (XL)

Department of Hematology, He Ping Central Hospital of the Changzhi Medical College, Changzhi, P.R. China.

Lin-Hua Yang (LH)

Department of Hematology, Second Hospital of Shanxi Medical University, Taiyuan, P.R. China.

Jian-Da Hu (JD)

Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, P.R. China.

Ren-Wei Huang (RW)

Department of Hematology, Third Affiliated Hospital of Southern Medical University, Guangzhou, P.R. China.

Zhong-Xing Jiang (ZX)

Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, P.R. China.

Jing-Wen Wang (JW)

Department of Hematology, Beijing Tongren Hospital, Beijing, P.R. China.

Hong-Yu Zhang (HY)

Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, P.R. China.

Zhen Xiao (Z)

Department of Hematology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, P.R. China.

Si-Yan Zhan (SY)

Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P.R. China.

Hui-Xin Liu (HX)

Department of Clinical Epidemiology, Peking University People's Hospital, Beijing, P.R. China.

Xing-Lin Wang (XL)

Peking University People's Hospital, Beijing, P.R. China.

Ying-Jun Chang (YJ)

Peking University People's Hospital, Beijing, P.R. China.

Yu Wang (Y)

Peking University People's Hospital, Beijing, P.R. China.

Yuan Kong (Y)

Peking University People's Hospital, Beijing, P.R. China.

Lan-Ping Xu (LP)

Peking University People's Hospital, Beijing, P.R. China.

Kai-Yan Liu (KY)

Peking University People's Hospital, Beijing, P.R. China.

Xiao-Hong Zhang (XH)

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, P.R. China.

Cheng-Hong Yin (CH)

Department of Internal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China.

Yue-Ying Li (YY)

CAS Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, China National Center for Bioinformation, Beijing, P.R. China.

Qian-Fei Wang (QF)

CAS Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, China National Center for Bioinformation, Beijing, P.R. China.

Jian-Liu Wang (JL)

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, P.R. China.

Xiao-Jun Huang (XJ)

Peking University People's Hospital, Beijing, P.R. China.

Xiao-Hui Zhang (XH)

Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, P.R. China.
ORCID: 0000-0003-4730-256X

Classifications MeSH