Efficacy and safety of azathioprine plus prednisone versus prednisone alone as first-line treatment for antinuclear antibody-positive immune thrombocytopenia: a retrospective cohort study

References

• Cooper N, Ghanima W. Immune thrombocytopenia. N Engl J Med. 2019;381(10):945–955.
   PubMed Web of Science ®Google Scholar
• Liu Y, Chen S, Yang G, et al. ANA-positive primary immune thrombocytopaenia: a different clinical entity with increased risk of connective tissue diseases. Lupus Sci Med. 2021;8(1):e000523.
   PubMed Web of Science ®Google Scholar
• Altintas A, Ozel A, Okur N, et al. Prevalence and clinical significance of elevated antinuclear antibody test in children and adult patients with idiopathic thrombocytopenic purpura. J Thromb Thrombolysis. 2007;24(2):163–168.
   PubMed Web of Science ®Google Scholar
• Ahn SM, Choi EJ, Oh JS, et al. Prognostic factors for the development of systemic lupus erythematosus in patients with immune thrombocytopenia. Arthritis Res Ther. 2022;24(1):213.
   PubMed Web of Science ®Google Scholar
• Liu Q, Xu H, Guan X, et al. Clinical significance of antinuclear and antiextractable nuclear antigen antibody in childhood immune thrombocytopenia. Semin Thromb Hemost. 2017;43(6):629–634.
   PubMed Web of Science ®Google Scholar
• Bolton-Maggs PHB, George JN. Immune thrombocytopenia treatment. N Engl J Med. 2021;385(10):948–950.
   PubMed Web of Science ®Google Scholar
• Kochhar M, Neunert C. Immune thrombocytopenia: a review of upfront treatment strategies. Blood Rev. 2021;49:100822.
   PubMed Web of Science ®Google Scholar
• Huang QS, Liu Y, Wang JB, et al. All-trans retinoic acid plus high-dose dexamethasone as first-line treatment for patients with newly diagnosed immune thrombocytopenia: a multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Haematol. 2021;8(10):e688–e699.
   PubMed Web of Science ®Google Scholar
• Abbasi SY, Milhem M, Zaru L. A positive antinuclear antibody test predicts for a poor response to initial steroid therapy in adults with idiopathic thrombocytopenic purpura. Ann Hematol. 2008;87(6):459–462.
   PubMed Web of Science ®Google Scholar
• Broen JCA, van Laar JM. Mycophenolate mofetil, azathioprine and tacrolimus: mechanisms in rheumatology. Nat Rev Rheumatol. 2020;16(3):167–178.
   PubMed Web of Science ®Google Scholar
• Fu Q, Wu C, Dai M, et al. Leflunomide versus azathioprine for maintenance therapy of lupus nephritis: a prospective, multicentre, randomised trial and long-term follow-up. Ann Rheum Dis. 2022;81(11):1549–1555.
   PubMed Web of Science ®Google Scholar
• Reynolds JA, Gayed M, Khamashta MA, et al. Outcomes of children born to mothers with systemic lupus erythematosus exposed to hydroxychloroquine or azathioprine. Rheumatology (Oxford). 2022;62(3):1124–1135.
   Web of Science ®Google Scholar
• Wilson L, Tuson S, Yang L, et al. Real-World Use of azathioprine metabolites changes clinical management of inflammatory bowel disease. J Can Assoc Gastroenterol. 2021;4(3):101–109.
   PubMedGoogle Scholar
• Mishra K, Pramanik S, Sandal R, et al. Safety and efficacy of azathioprine in immune thrombocytopenia. Am J Blood Res. 2021;11(3):217–226.
   PubMed Web of Science ®Google Scholar
• Neunert C, Lim W, Crowther M, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190–4207.
   PubMed Web of Science ®Google Scholar
• Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829–3866.
   PubMed Web of Science ®Google Scholar
• Thrombosis, Hemostasis Group CSoHCMA. Chinese guideline on the diagnosis and management of adult primary immune thrombocytopenia (version 2020). Zhonghua Xue Ye Xue Za Zhi. 2020;41(8):617–623.
   PubMedGoogle Scholar
• Poudyal BS, Sapkota B, Shrestha GS, et al. Safety and efficacy of azathioprine as a second line therapy for primary immune thrombocytopenic purpura. JNMA J Nepal Med Assoc. 2016;55(203):16–21.
   PubMedGoogle Scholar
• Chang H, Tang TC, Hung YS, et al. Immune thrombocytopenia: effectiveness of frontline steroids and comparison of azathioprine, splenectomy, and rituximab as second-line treatment. Eur J Haematol. 2018;101(4):549–555.
   PubMed Web of Science ®Google Scholar
• Abdallah GEM, Elbiih EAS, Sayed D, et al. Revisiting the management of chronic ITP; a randomized controlled clinical trial. Platelets. 2021;32(2):243–249.
   PubMed Web of Science ®Google Scholar
• Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113(11):2386–2393.
   PubMed Web of Science ®Google Scholar
• von Muhlen CA, Garcia-De La Torre I, Infantino M, et al. How to report the antinuclear antibodies (anti-cell antibodies) test on HEp-2 cells: guidelines from the ICAP initiative. Immunol Res. 2021;69(6):594–608.
   PubMed Web of Science ®Google Scholar
• Li HQ, Zhang L, Zhao H, et al. Chronic idiopathic thrombocytopenic purpura in adult Chinese patients: a retrospective single-centered analysis of 1791 cases. Chin Med J (Engl). 2005;118(1):34–37.
   PubMed Web of Science ®Google Scholar
• Baysal M, Bas V, Umit E, et al. Could antinuclear antibody positivity be a factor affecting treatment response in immune thrombocytopenia patients on eltrombopag? Turk J Haematol. 2022;39(1):38–42.
   PubMed Web of Science ®Google Scholar
• Wang YM, Yu YF, Liu Y, et al. The association between antinuclear antibody and response to rituximab treatment in adult patients with primary immune thrombocytopenia. Hematology. 2020;25(1):139–144.
   PubMed Web of Science ®Google Scholar
• Neunert CE, Cooper N. Evidence-based management of immune thrombocytopenia: ASH guideline update. Hematology Am Soc Hematol Educ Program. 2018;2018(1):568–575.
   PubMed Web of Science ®Google Scholar
• Audia S, Mahevas M, Samson M, et al. Pathogenesis of immune thrombocytopenia. Autoimmun Rev. 2017;16(6):620–632.
   PubMed Web of Science ®Google Scholar
• Xu J, Wang G, Tan S, et al. The clinical effect of Prednisone in combination with mycophenolate mofetil on idiopathic thrombocytopenic purpura (ITP) and its influence on the level of peripheral blood T lymphocytes and NK lymphocytes. Saudi J Biol Sci. 2019;26(8):2108–2112.
   PubMed Web of Science ®Google Scholar
• Okoye IS, Xu L, Walker J, et al. The glucocorticoids prednisone and dexamethasone differentially modulate T cell function in response to anti-PD-1 and anti-CTLA-4 immune checkpoint blockade. Cancer Immunol Immunother. 2020;69(8):1423–1436.
   PubMed Web of Science ®Google Scholar
• Scharf RE. Thrombocytopenia and hemostatic changes in acute and chronic liver disease: pathophysiology, clinical and laboratory features, and management. J Clin Med. 2021;10(7):1530.
   PubMed Web of Science ®Google Scholar
• van Dievoet MA, Eeckhoudt S, Stephenne X. Primary hemostasis in chronic liver disease and cirrhosis: what Did We learn over the past decade? Int J Mol Sci. 2020;21(9):3294.
   PubMed Web of Science ®Google Scholar
• Wei Y, Ji XB, Wang YW, et al. High-dose dexamethasone vs prednisone for treatment of adult immune thrombocytopenia: a prospective multicenter randomized trial. Blood. 2016;127(3):296–302. quiz 370.
   PubMed Web of Science ®Google Scholar