AUTHOR=Xiao Qirong , Lin Bicun , Wang Hanyu , Zhan Weiwu , Chen Ping 

TITLE=The Efficacy of High-Dose Dexamethasone vs. Other Treatments for Newly Diagnosed Immune Thrombocytopenia: A Meta-Analysis

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.656792

DOI=10.3389/fmed.2021.656792

ISSN=2296-858X

ABSTRACT=<p><bold>Objective:</bold> To compare the therapeutic efficacies of high dose dexamethasone, prednisone and rituximab in combination with dexamethasone for newly diagnosed ITP (Immune Thrombocytopenia, ITP) patients.</p><p><bold>Methods and results:</bold> Relevant publications for this study were obtained by searching PubMed, Embase, Cochrane, and CNKI (National Knowledge Infrastructure, CNKI) databases following the PRISMA guidelines. A total of, 15 publications were retrieved that contained sufficient data from 1,362 patients for high quality analysis of this study endpoints. Data analysis was carried out using Stata 11.0 software.</p><p>The primary outcomes were OR (Overall Response, OR) at 1 month after intervention and SR at 6 and 12 months. The secondary outcomes were AEs and relapse. There were no differences in the OR, while the SR was higher at 6 months (<italic>p</italic> = 0.001) as well as 12 months (<italic>p</italic> &lt; 0.001) in the rituximab + dexamethasone group. In addition, the incidences of AEs (<italic>p</italic> = 0.008) were also higher in the rituximab + dexamethasone group. Dexamethasone was superior to prednisone based on OR (<italic>p</italic> = 0.006). We found no differences in SR at 6 months between dexamethasone and prednisone but SR at 12 months was higher in the dexamethasone group (<italic>p</italic> = 0.014). The relapse rate was higher in the high dose dexamethasone group compared to the rituximab + dexamethasone group (<italic>p</italic> = 0.042).</p><p><bold>Conclusion:</bold> This demonstrated that new treatment options such as Rituximab + dexamethasone, could be a good alternative to traditional therapy in improving long-term response and reducing the rate of relapse. However, further studies are required on the increased risk of AEs associated with Rituximab + dexamethasone.</p>