An evaluation of cyclosporin and corticosteroids individually as adjuncts to plasma exchange in the treatment of thrombotic thrombocytopenic purpura.
We present the results of two consecutively performed cohort studies that evaluated the clinical effects of corticosteroids or cyclosporin as an adjunct to plasma exchange (PE) for the treatment of an acute episode of thrombotic thrombocytopenic purpura (TTP). In comparing 12 corticosteroid-treated patients with eight cyclosporin-treated patients, none of the cyclosporin-treated patients suffered an exacerbation or recurrence of TTP in the first 30 d after discontinuing PE compared with 6/10 (60%) of the corticosteroid-treated patients (P = 0.042). These data suggest that cyclosporin may have advantages over corticosteroids as an adjunct to PE therapy in the initial treatment of idiopathic TTP.
Cataland
Spero R
SR
Division of Hematology/Oncology, Department of Internal Medicine, Ohio state University, Columbus, OH 43210, USA. spero.cataland@osumc.edu
Jin
Ming
M
Ferketich
Amy K
AK
Kennedy
Melanie S
MS
Kraut
Eric H
EH
George
James N
JN
Wu
Haifeng M
HM
D051722:ADAM Proteins / Q000097:blood / Q000276:immunology; D000071120:ADAMTS13 Protein; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D017024:Chemotherapy, Adjuvant; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D011446:Prospective Studies; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D012074:Remission Induction
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human