Assessing the impact of rituximab treatment on patient outcomes in idiopathic thrombocytopenic purpura
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by increased platelet destruction and impaired platelet production. While high-dose dexamethasone (DXM) and other corticosteroids remain first-line therapy, many patients experience relapse or develop resistance. Patients and methods In this prospective study, 60 adult patients with ITP were randomized to receive DXM alone (n=20), low-dose rituximab (100 mg weekly for 4 weeks) plus DXM (n=20), or standard-dose rituximab (375 mg/m² weekly for 4 weeks) plus DXM (n=20). The primary endpoint was complete response rate (platelet count ≥100 × 10⁹/l) at week 24. Secondary endpoints included overall response at weeks 4 and 12, time to response, sustained response at 6 months, relapse rate, and safety profile. Results At week 24, complete response rates were significantly higher in both rituximab groups compared with DXM alone (low-dose: 55%, standard-dose: 65%, DXM alone: 10%; P <0.001). Median time to response was shorter in rituximab groups (low-dose: 8 days, standard-dose: 7 days, DXM alone: 12 days; P =0.008). Sustained response at 6 months was achieved in 60% of low-dose rituximab patients and 70% of standard-dose rituximab patients versus 30% with DXM alone ( P =0.003). Conclusion Addition of rituximab to DXM significantly improves response rates and treatment durability in adult ITP patients compared with DXM alone. Low-dose rituximab shows comparable efficacy to standard-dose rituximab with a potentially improved safety profile, suggesting it may be a preferred treatment strategy, particularly in resource-limited settings.
Institutions: Assiut University Hospitals, Assiut University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7119894216