Currently submitted to: JMIR Preprints
Date Submitted: Nov 28, 2025
Open Peer Review Period: Nov 28, 2025 - Nov 13, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
High-Dose Dexamethasone for the Treatment of Immune Thrombocytopenia: A Randomized Controlled Trial
ABSTRACT
Introduction Immune thrombocytopenic purpura (ITP) is an acquired thrombocytopenia syndrome characterized by platelet destruction due to antiplatelet antibodies. Corticosteroids are the first-line treatment for adult patients with ITP. This study compares the effects of high-dose dexamethasone versus prednisolone in ITP treatment. Materials and Methods This open-label clinical trial involved patients over 18 years diagnosed with ITP (based on ASH criteria) who had not received prior treatment. Participants were randomly assigned (1:1) to receive high-dose dexamethasone (HD-DXM) or prednisolone (PDN). The dexamethasone group received 40 mg intravenously for 4 consecutive days, while the PDN group received 1 mg/kg oral prednisolone for 4 weeks. Daily complete blood counts were obtained to assess treatment response, defined as a platelet count above 30,000/μL. Results A total of 36 patients were evaluated, with 18 in each treatment group. Patients receiving dexamethasone showed significantly reduced hospitalization duration and faster time to reach platelet counts above 30,000/μL (P=0.01 and P=0.002, respectively). Conclusion High-dose dexamethasone significantly decreases the time to initial response and hospitalization duration in ITP patients compared to prednisolone.
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