Annals of internal medicine · 1988
Danazol for the treatment of refractory autoimmune thrombocytopenia in systemic lupus erythematosus.
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West S G, Johnson S C
Аннотация
STUDY OBJECTIVE: to determine the efficacy of danazol therapy in patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to other therapies.
DESIGN: noncontrolled clinical trial, with a minimum of 8 weeks of therapy, the maximum determined by clinical response.
SETTING: referral-based rheumatology clinic at an army medical center.
PATIENTS: sequential sample of six patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to high-dose glucocorticoids. Four patients also failed splenectomy, or cytotoxic drugs, or both.
INTERVENTIONS: danazol, 200 mg four times per day, was added to the previous therapeutic regimen for at least 2 months.
MEASUREMENTS AND MAIN RESULTS: all six patients had normal platelet counts within 6 weeks of starting danazol treatment. After resolution of thrombocytopenia for at least 1 month, immunosuppressive medications were tapered; one patient had a relapse. During an average follow-up of 12 months, the danazol dose was lowered in the five remaining patients but could not be discontinued without recurrence of thrombocytopenia. During danazol therapy, platelet-bound IgG antibodies and circulating immune complexes did not decrease significantly. Danazol was well tolerated.
CONCLUSIONS: danazol appears to be a useful adjunctive treatment for refractory autoimmune thrombocytopenia associated with systemic lupus erythematosus.
DESIGN: noncontrolled clinical trial, with a minimum of 8 weeks of therapy, the maximum determined by clinical response.
SETTING: referral-based rheumatology clinic at an army medical center.
PATIENTS: sequential sample of six patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to high-dose glucocorticoids. Four patients also failed splenectomy, or cytotoxic drugs, or both.
INTERVENTIONS: danazol, 200 mg four times per day, was added to the previous therapeutic regimen for at least 2 months.
MEASUREMENTS AND MAIN RESULTS: all six patients had normal platelet counts within 6 weeks of starting danazol treatment. After resolution of thrombocytopenia for at least 1 month, immunosuppressive medications were tapered; one patient had a relapse. During an average follow-up of 12 months, the danazol dose was lowered in the five remaining patients but could not be discontinued without recurrence of thrombocytopenia. During danazol therapy, platelet-bound IgG antibodies and circulating immune complexes did not decrease significantly. Danazol was well tolerated.
CONCLUSIONS: danazol appears to be a useful adjunctive treatment for refractory autoimmune thrombocytopenia associated with systemic lupus erythematosus.