Objective: To compare the therapeutic efficacies of high dose
dexamethasone,
prednisone and
rituximab in combination with
dexamethasone for newly diagnosed
ITP (
Immune Thrombocytopenia,
ITP) patients. Methods and results: Relevant publications for this study were obtained by searching PubMed, Embase, Cochrane, and CNKI (National Knowledge Infrastructure, CNKI) databases following the
PRISMA guidelines. A total of, 15 publications were retrieved that contained sufficient data from 1,362 patients for high quality analysis of this study endpoints. Data analysis was carried out using Stata 11.0 software. The primary outcomes were OR (Overall Response, OR) at 1 month after intervention and
SR at 6 and 12 months. The secondary outcomes were AEs and relapse. There were no differences in the OR, while the SR was higher at 6 months (p = 0.001) as well as 12 months (p < 0.001) in the
rituximab +
dexamethasone group. In addition, the incidences of AEs (p = 0.008) were also higher in the
rituximab +
dexamethasone group.
Dexamethasone was superior to
prednisone based on OR (p = 0.006). We found no differences in
SR at 6 months between
dexamethasone and
prednisone but
SR at 12 months was higher in the
dexamethasone group (p = 0.014). The relapse rate was higher in the high dose
dexamethasone group compared to the
rituximab +
dexamethasone group (p = 0.042). Conclusion: This demonstrated that new treatment options such as
Rituximab +
dexamethasone, could be a good alternative to traditional
therapy in improving long-term response and reducing the rate of relapse. However, further studies are required on the increased risk of AEs associated with
Rituximab +
dexamethasone.