Initial management of immune thrombocytopenic purpura in adults: A randomized controlled trial comparing intermittent anti-D with routine care

Abstract

We conducted a randomized clinical trial in adults with a new diagnosis of ITP and a platelet count P = 0.045 at 100 days after randomization, P = 0.840 at 1 year after randomization, using log‐rank analysis). Patients in the anti‐D group were treated with prednisone for fewer days (70 days) compared to the routine care group (112 days, P = 0.01). No major bleeding events occurred. In this study, initial treatment of patients with intermittent anti‐D initially deferred splenectomy. Whether our aggressive regimen of anti‐D could have prevented splenectomy if it had been adhered to in all patients remains uncertain. However, compliance with this anti‐D regimen was not feasible for many patients and/or their physicians. Am. J. Hematol. 74:161–169, 2003.