Systemic corticosteroids in the treatment of warm autoimmune hemolytic anemia: A clinical setting perspective

There are unmet answers about the effect of the different forms of corticosteroids in the treatment of the warm autoimmune hemolytic anemia (WAIHA). We aimed to describe the initial response rate and the safety profile of different regimens and forms of parenteral corticosteroids versus the solo ora...

Full description

Saved in:

Bibliographic Details
Published in:	Blood cells, molecules, & diseases Vol. 92; p. 102621
Main Authors:	Abdallah, Ghada E.M., Abbas, Wael A., Elbeih, Esam A.S., Abdelmenam, Ehab, Mohammed Saleh, Mostafa F.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-12-2021
Subjects:	Administration, Intravenous Administration, Oral Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - therapeutic use Adult Aged Anemia Anemia, Hemolytic, Autoimmune - drug therapy Autoimmune Corticosteroids Dexamethasone - administration & dosage Dexamethasone - therapeutic use Female Hemolytic Humans Male Methylprednisolone - administration & dosage Methylprednisolone - therapeutic use Middle Aged Prednisolone - administration & dosage Prednisolone - therapeutic use Treatment Outcome Young Adult Autoimmune Corticosteroids Hemolytic Anemia
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	There are unmet answers about the effect of the different forms of corticosteroids in the treatment of the warm autoimmune hemolytic anemia (WAIHA). We aimed to describe the initial response rate and the safety profile of different regimens and forms of parenteral corticosteroids versus the solo oral prednisolone as first-line strategies for newly diagnosed adult WAIHA. We recruited 156 patients who treated with either oral prednisolone 1 mg/kg daily for 3 weeks or intravenous corticosteroids like dexamethasone 40 mg daily for 4 days, Methylprednisolone 1 g/day for 3 days, or Methylprednisolone 1 g/day for 5 days then followed by oral prednisolone 1 mg/kg/day for 3 weeks. Full clinical and laboratory evaluations were done every 3 days for 3 weeks. The primary outcome was the rate of response at the end of the third-week post treatment. The rate of response was more in the group started the treatment intravenously (81.6% versus 41.7% and p = 0.0001). Multivariate cox regression analysis proved the predictivity of intravenous corticosteroid therapy for initial response. The safety profile of the different forms and regimens of corticosteroids were comparable. Therefore, parenteral regimens can be used as a rescue treatment in severe cases of WAIHA.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1079-9796 1096-0961
DOI:	10.1016/j.bcmd.2021.102621