What is the role of corticosteroids in the treatment of immune thrombocytopenic purpura (ITP)?

Updated: Jun 28, 2019
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Although the paradigm may be shifting somewhat with the expanding experience with thrombopoietin receptor analogs in chronic ITP, the long-term consequences associated with their use remain to be established and the delayed platelet count responses these agents produce are not conducive to preventing or reversing the potential of acute bleeding complications in newly diagnosed ITP. Therefore, for the present, corticosteroids (ie, oral prednisone, intravenous [IV] methylprednisolone, or high-dose dexamethasone) [9, 10, 11] should remain the drugs of choice for the initial management of acute ITP. Treatment with corticosteroids may not only reduce the rate of platelet destruction but may also rapidly alter endothelial cell integrity to facilitate primary hemostasis and to reduce bleeding and bruising.


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