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. 2017 Oct 30;12(10):e0187296.
doi: 10.1371/journal.pone.0187296. eCollection 2017.

Efficacy and safety of dapsone as second line therapy for adult immune thrombocytopenia: A retrospective study of 42 patients

Clémentine Estève  1 , Maxime Samson  1 , Alexandre Guilhem  1 , Barbara Nicolas  1 , Vanessa Leguy-Seguin  1 , Sabine Berthier  1 , Bernard Bonnotte  1 , Sylvain Audia  1
Affiliations

Efficacy and safety of dapsone as second line therapy for adult immune thrombocytopenia: A retrospective study of 42 patients

Clémentine Estève et al. PLoS One. .

Abstract

Dapsone is recommended as a second line therapy in immune thrombocytopenia (ITP), but is underused because of its potential side effects. The medical charts of 42 ITP patients treated with dapsone (100 mg/day) were retrospectively reviewed in order to assess its efficacy and safety in daily clinical practice. The overall response rate was 54.8% (n = 22, with a complete response in 38.1%) with a median time to response of 29 days (24-41 days). Patients with complete response had shorter disease duration whereas no difference was observed between responders and non-responders regarding age, sex or previous treatments received. Importantly, after dapsone withdrawal, a sustained response was observed in 5 patients, representing 12% of the whole cohort. Twenty percent of patients (n = 8) relapsed on therapy after 8.1 (6.5-13.6) months. Side effects occurred in 31% (n = 13) of patients, and required dapsone withdrawal in 22% (n = 9) or dosage reduction in 10% (n = 4) of the cases. Side effects resolved in all but one case. Overall, these data support dapsone as an interesting second line therapy in ITP, with a good safety and efficacy profile at a low cost.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of the study.
Fig 2
Fig 2. Platelet count before and after 4 weeks dapsone was started, in responders (n = 23) and non-responder patients (n = 19).
P-value derived by Wilcoxon matched pairs test.
Fig 3
Fig 3. Flowchart of dapsone-treated patients.
Follow-up is given by median (1st-3rd interquartile).
See this image and copyright information in PMC

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