More from Jason Freed
Dex 40 mg daily x 4 is my treatment of choice for essentially all patients with newly diagnosed ITP because it “concentrates the pain” of steroids into a short duration and (based upon one small RCT) has slightly better outcomes. Dexamethasone 40mg is associated with quicker responses than prednisone and no difference in adverse events. Median time to response is 3 days which helps you get people home from the hospital quickly. 80% respond within 1 month and 40% have a sustained response. If platelets are still <30 at 10 days from start, a second course of dexamethasone 40mg x 4 days will work in 50% of patients who didn’t respond to the first course.