Treating ITP With Corticosteroids

Corticosteroids (such as prednisone) are often the first-line treatment for idiopathic thrombocytopenic purpura (ITP). These steroids, based on a naturally occurring hormone produced in the adrenal glands, may be given in several ways, including by injection, orally and topically.

Corticosteroids help raise platelet counts by suppressing the immune system. For most patients—roughly 50% to 90%—these drugs quickly raise platelet levels; for 30% of people with ITP, however, a second form of treatment or a lower dose of steroids may have to be prescribed. Long-term use of corticosteroids isn’t suggested, because of the risk of serious side effects like cataracts and high blood sugar.

Whether the ITP treatment is successful or not, anyone stopping a high dose of steroids should gradually taper off use. Doing this will prevent a shock to the system by giving your adrenal glands time to resume natural hormone production. Stopping corticosteroids suddenly can cause serious health problems.

Corticosteroids have side effects, though not all patients will develop them. Among the possible ones are:

• cataracts
• gastrointestinal discomfort
• obesity
• moon (round) face
• osteoporosis
• high blood pressure
• blood sugar changes
• insomnia
• mood changes
• muscle wasting
• potassium loss
• skin changes

These side effects can be difficult to manage and can increase in severity if treatment lasts for a long time, but side effects can be lessened if the following measures are taken.

• trying lower doses or intermittent dosing
• using steroids only when necessary
• using the minimal dose required to control ITP
• monitoring blood pressure
• taking calcium supplements to maintain strong bones
• exercising to combat muscle weakness and osteoporosis

Work closely with your healthcare provider when you're taking corticosteroids to address any side effects or when discontinuing or tapering off the drugs.