Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy : a national retrospective cohort study
© The Author(s), 2022..
Background: 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 versus prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP).
Methods: 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: 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; p < 0.001), and between the IVIg group (6.71 ± 4.85 days) and prednisone group (p < 0.001). The median prednisone duration in the monotherapy group was 27 days (range, 8-195 days), whereas that in the combination group was 14 days (range, 6-85 days). No significant differences were found among these three treatment groups in neonatal outcomes, particularly concerning the neonatal platelet counts. The time to response in the combination treatment group was shorter than prednisone monotherapy. The duration of prednisone application in combination group was shorter than prednisone monotherapy. The combined therapy showed a lower predelivery platelet transfusion rate than IVIg alone.
Conclusion: These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
|---|---|
| Enthalten in: |
Therapeutic advances in hematology - 13(2022) vom: 08., Seite 20406207221095226 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zhu, Xiao-Lu [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Immune thrombocytopenia |
|---|
| Anmerkungen: |
Date Revised 16.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1177/20406207221095226 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM340388641 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM340388641 | ||
| 003 | DE-627 | ||
| 005 | 20231226005108.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/20406207221095226 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1134.xml |
| 035 | |a (DE-627)NLM340388641 | ||
| 035 | |a (NLM)35510211 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Zhu, Xiao-Lu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy |b a national retrospective cohort study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s), 2022. | ||
| 520 | |a Background: 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 versus prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP) | ||
| 520 | |a Methods: 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 | ||
| 520 | |a Results: 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; p < 0.001), and between the IVIg group (6.71 ± 4.85 days) and prednisone group (p < 0.001). The median prednisone duration in the monotherapy group was 27 days (range, 8-195 days), whereas that in the combination group was 14 days (range, 6-85 days). No significant differences were found among these three treatment groups in neonatal outcomes, particularly concerning the neonatal platelet counts. The time to response in the combination treatment group was shorter than prednisone monotherapy. The duration of prednisone application in combination group was shorter than prednisone monotherapy. The combined therapy showed a lower predelivery platelet transfusion rate than IVIg alone | ||
| 520 | |a Conclusion: These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a immune thrombocytopenia | |
| 650 | 4 | |a intravenous immunoglobulin | |
| 650 | 4 | |a prednisone | |
| 650 | 4 | |a pregnant | |
| 700 | 1 | |a Feng, Ru |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Qiu-Sha |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Mei-Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Yao, Hong-Xia |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Qian, Shen-Xian |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Tong-Hua |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jing-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Xu-Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Lin-Hua |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Jian-Da |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Ren-Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Zhong-Xing |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jing-Wen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Hong-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Xiao, Zhen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhan, Si-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Hui-Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xing-Lin |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Ying-Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Kong, Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Lan-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kai-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xiao-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Yin, Cheng-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yue-Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Qian-Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jian-Liu |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Xiao-Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xiao-Hui |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Therapeutic advances in hematology |d 2010 |g 13(2022) vom: 08., Seite 20406207221095226 |w (DE-627)NLM224608940 |x 2040-6207 |7 nnns |
| 773 | 1 | 8 | |g volume:13 |g year:2022 |g day:08 |g pages:20406207221095226 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/20406207221095226 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 13 |j 2022 |b 08 |h 20406207221095226 | ||