Itp steroid response

The table below is based on the pooled safety data on all LEMTRADA 12 mg-treated patients during all available follow up in clinical trials. Adverse reactions occurring in ≥% of patients are listed by Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC) and Preferred Term (PT). Frequencies are defined according to the following convention: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); Not known (cannot be estimated from the available data). Within each frequency grouping, adverse reactions have been presented in order of decreasing seriousness.

Whitington and Kelly (2008) stated that neonatal hemochromatosis (NH) is the result of severe fetal liver injury that seems to result from maternal-fetal alloimmunity.  Women who have had an infant affected with NH are at high-risk in subsequent pregnancies for having another affected infant.  This study was designed to examine if therapy directed at limiting the severity of gestational alloimmunity can reduce the occurrence of severe NH in infants of women at risk.  A secondary objective was to use a prospectively collected data set to examine questions of vital interest about NH.  Women with a history of pregnancy ending in documented NH were treated with IVIG at 1 g/kg of body weight weekly from the 18th week until the end of gestation.  Extensive data were prospectively collected regarding the gestational histories of the subjects.  The outcomes of treated pregnancies were compared with those of previous affected pregnancies, which were used as historical controls.  A total of 48 women were enrolled to be treated during 53 pregnancies.  The gestational histories of these women demonstrated the high-risk of occurrence of NH: 92 % of pregnancies at risk resulted in intrauterine fetal demise, neonatal death, or liver failure necessitating transplant.  In contrast, with gestational therapy, the 53 at-risk gestations resulted in 3 failures and 52 infants who survived intact with medical therapy alone.  When compared on a per-woman or per-infant basis, the outcome of gestation at risk for NH was improved by gestational therapy.  The authors concluded that NH seems to be the result of a gestational alloimmune disease, and occurrence of severe NH in at-risk pregnancies can be significantly reduced by treatment with high-dose IVIG during gestation.

The proportion of patients who achieved an overall initial response was higher in the group that received HD-DXM (% vs. % in the prednisone group, P = .044) and the rate of complete response also favored HD-DXM (% vs. %; p=). Additionally, patients on the HD-DXM arm responded more quickly. The likelihood of achieving a sustained response was similar: 40 percent in the HD-DXM arm and percent in the prednisone arm (P = ). While the frequency of some adverse effects (., mood disorder or insomnia) was similar in both groups, weight gain and/or Cushingoid appearance affected more than 10 percent of the prednisone-treated patients (vs. none of the patients treated with HD-DXM).

If the above treatments do not work, there are several other options. For example, you may be given another trial of steroids or IVIg. Other treatments that may be used include danazol and medications to suppress the immune system, such as azathioprine or ciclosporin . A medicine called rituximab has also produced good responses. Other new treatments include medicines which help you make more platelets. These are called romiplostim and eltrombopag. They may be used if you are having severe bleeding, and if other treatments have not been helpful.

Itp steroid response

itp steroid response

If the above treatments do not work, there are several other options. For example, you may be given another trial of steroids or IVIg. Other treatments that may be used include danazol and medications to suppress the immune system, such as azathioprine or ciclosporin . A medicine called rituximab has also produced good responses. Other new treatments include medicines which help you make more platelets. These are called romiplostim and eltrombopag. They may be used if you are having severe bleeding, and if other treatments have not been helpful.

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