AUTHOR=Xu Xue , Liang Mei-Ying , Wang Yi-Lin , Wang Jian-Liu , Zhang Xiao-Hui 

TITLE=Lower-dose corticosteroid therapy in severe immune thrombocytopenia during pregnancy: The comparable efficacy and lower incidence of maternal complications

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.983734

DOI=10.3389/fphar.2022.983734

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> This study assessed the clinical efficacy of oral prednisone at low dose (LD) <italic>versus</italic> the previous high-dose (HD) study in patients with severe immune thrombocytopenia during pregnancy and its side effects on maternal and neonatal outcomes.</p><p><bold>Study design:</bold> Pregnant patients with ITP were enrolled in the study (platelet count &lt;30×10<sup>9</sup>/L) between January 2015 and 2019. A total of 43 patients received LD oral prednisone (0.25–0.5 mg/kg) as the initial treatment and were compared retrospectively with the 31 patients in the HD (1 mg/kg) study. The primary clinical endpoint was the response rate, and the secondary endpoint was maternal hemorrhagic events, complications, and neonatal outcomes.</p><p><bold>Results:</bold> In total, 35% of patients responded (15/43) to the LD cortico-therapy, including four patients with a complete response which was no less than HD therapy (35.5%). The bleeding symptoms of 10 (30%) patients were ameliorated after 14 days of LD prednisone treatment. Preeclampsia occurred in three cases (7% of total) of which the incidence was obviously lower than that of the previous study at HD (18%). No stillbirth or miscarriage occurred in the LD group, and neonatal outcomes had no significant differences between the two studies.</p><p><bold>Conclusion:</bold> LD prednisone therapy for severe ITP patients during pregnancy had equal efficacy to HD treatment. In addition, the decrease in dosage significantly reduced the incidence of hypertension.</p>