Corticosteroids plus metformin versus corticosteroids as front‐line treatment for patients with newly diagnosed ITP and pre‐existing type 2 diabetes mellitus: A multicentre propensity score‐matched study

Corticosteroids are the standard first-line treatment for primary immune thrombocytopenia (ITP), with a high initial response but unsatisfactory sustained response (SR). Additionally, corticosteroids usually lead to hyperglycaemia especially in patients with pre-existing type 2 diabetes mellitus (T2DM). Besides reducing the blood glucose levels, metformin was found to have immunomodulatory effects. We hereby conducted a multicentre propensity score matching analysis of corticosteroids plus metformin versus corticosteroids for newly diagnosed ITP patients with pre-existing T2DM. After matching at a ratio of 1:1, there were 57 patients in each group. Baseline characteristics, comorbidities and other medications including concurrent hypoglycaemic medications were balanced between the two groups. No statistical difference was observed in the initial response rate at day 14. It was notable that patients in the metformin group had a significantly higher SR rate and longer duration of response compared to the non-metformin group. Metformin inclusion was associated with a higher incidence of stomach upset, which were generally tolerable. Our study provided evidence that the addition of metformin to corticosteroids might be a promising front-line treatment for newly diagnosed ITP patients with pre-existing T2DM.

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Publication Details

Journal
British Journal of Haematology
Published
2024-12-18
DOI
https://doi.org/10.1111/bjh.19940
Citations
1
Primary Topic
Platelet Disorders and Treatments
Type
article
Field-Weighted Citation Impact
0.45

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article

Corticosteroids plus metformin versus corticosteroids as front‐line treatment for patients with newly diagnosed ITP and pre‐existing type 2 diabetes mellitus: A multicentre propensity score‐matched study

Yajing Zhao, Qiu‐yan Wang, Qiaofeng Dong, Shuang Liu et al.
1 citations
British Journal of Haematology
Platelet Disorders and Treatments
0.45
article

Corticosteroids plus metformin versus corticosteroids as front‐line treatment for patients with newly diagnosed ITP and pre‐existing type 2 diabetes mellitus: A multicentre propensity score‐matched study

Yajing Zhao, Qiu‐yan Wang, Qiaofeng Dong, Shuang Liu, Jun Peng, Christine Do Cao, Ji Ma, Zhenyu Yan, Ming Hou, Jian Chen, Yanming Wang, Liang Wang, Xinru Wang, Lin Sun, Xinguang Liu, Zhixin Xu, Li Zhao, Na Gao, Ya‐Wen Wang, X T Hou
article en
1 citations

Abstract

Corticosteroids are the standard first-line treatment for primary immune thrombocytopenia (ITP), with a high initial response but unsatisfactory sustained response (SR). Additionally, corticosteroids usually lead to hyperglycaemia especially in patients with pre-existing type 2 diabetes mellitus (T2DM). Besides reducing the blood glucose levels, metformin was found to have immunomodulatory effects. We hereby conducted a multicentre propensity score matching analysis of corticosteroids plus metformin versus corticosteroids for newly diagnosed ITP patients with pre-existing T2DM. After matching at a ratio of 1:1, there were 57 patients in each group. Baseline characteristics, comorbidities and other medications including concurrent hypoglycaemic medications were balanced between the two groups. No statistical difference was observed in the initial response rate at day 14. It was notable that patients in the metformin group had a significantly higher SR rate and longer duration of response compared to the non-metformin group. Metformin inclusion was associated with a higher incidence of stomach upset, which were generally tolerable. Our study provided evidence that the addition of metformin to corticosteroids might be a promising front-line treatment for newly diagnosed ITP patients with pre-existing T2DM.

British Journal of HaematologyVol. 208(2)
Binzhou Medical University (CN), Shandong University of Aeronautics (CN), Yuhuangding Hospital (CN), Shandong Tumor Hospital (CN), Jinan Central Hospital (CN), Hebei Yiling Hospital (CN), North China University of Science and Technology Affiliated Hospital (CN), Shengli Oilfield Central Hospital (CN), Jining First People's Hospital (CN), Heze Municipal Hospital (CN), Taian City Central Hospital (CN), Liaocheng People's Hospital (CN), Qilu Hospital of Shandong University (CN), Shandong First Medical University (CN)
National Natural Science Foundation of China, Natural Science Foundation of Shandong Province
Good health and well-being
Openalex Percentile: Top 28%
Platelet Disorders and Treatments
0.45
DOIOpen Access PDFOpenAlex
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