Corticosteroids are first-line therapy for ITP.

Prednisone 0.5-2 mg/kg/day for 1-4 weeks followed by a gradual taper is the conventional strategy.1 While prednisone results in response in up to two-thirds of patients, most patients eventually require subsequent therapies. Additionally, adverse effects of prolonged corticosteroid use can be significant.

Cheng and colleagues introduced a single course of high-dose dexamethasone for treatment-naïve ITP. Among 125 patients treated, high-dose dexamethasone was observed to results in an 85% initial response rate and a 42% sustained response rate at 6 months.2 Similar results were observed in a subsequent cohort study.3 Importantly, neither study included prednisone as a comparator.

Wei and colleagues undertook the current study to compare the efficacy and safety of high-dose dexamethasone vs. conventional prednisone therapy.

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