CLINICAL STATISTICS AND EFFECTIVENESS OF DIFFERENT TREATMENTS OF IDIOPATHIC THROMBOCYTOPENIC PURPURA

被引:0
|
作者
Kovaleva, L. G. [1 ]
Pustovaya, E. I. [1 ]
Safonova, T. I. [1 ]
Ryadnenko, A. A. [1 ]
Kolosova, E. N. [1 ]
机构
[1] Hematol Res Ctr, Moscow, Russia
关键词
idiopathic thrombocytopenic purpura; glucocorticosteroids; intravenous immunoglobulin; splenectomy; thrombopoietin receptor agonists; romiplostim; eltrombopag; ELTROMBOPAG; ROMIPLOSTIM; EFFICACY;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim. To ascertain efficacy of modern treatment methods in idiopathic thrombocytopenic purpura (ITP), to characterize basic indications for administration of these methods; perspective trends in ITP therapy. Material and methods. The article presents 20-year experience in observation and treatment of 1000 ITP patients gained from 1988 by the department of standardization of blood disease treatment methods on the basis of a consultative and outpatient department of Hematological Research Center. The results were assessed by conventional ITP treatment lines. Results. First-line therapy - glucocorticoids - provided remission in 70% patients, long-term (60 months and longer) in 14%, prednisolone resistance was in 19% patients. Intravenous immunoglobulin provided a rapid hemostatic effect (in 1-2 days) in all the patients. A positive response to treatment was seen in 86% patients but it was short-term (for a year and longer in 27%, resistance to the drug 14%). Second line treatment -splenectomy - is the most effective treatment: 80% remission, 32% patients had remission for longer than 60 months. Resistance occurred in 6% patients. Ineffectiveness of treatment in 20% patients stimulated the search for new pathogenetic treatment among synthetic analogues of thrombopoietin. Clinical trials proved high efficacy of two of them - eltrombopag and romiplostim (86-87% response), possible maintenance of remission in long-term interrupted administration of low doses. Conclusion. Modern ITP treatment allows a complete management of hemorrhagic syndrome and deep thrombocytopeny in 80% patients with provision of good quality of life and ability to work. Introduction into clinical practice of thrombopoietin analogues improves treatment results including in 20% patients resistant to all treatments in the absence of marked side effects even in long-term 3-year administration of such medication.
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页码:60 / 65
页数:6
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