Table 3. Randomized trials of high-dose... | American Society of Hematology

Table 3.

Randomized trials of high-dose dexamethasone vs prednisone

Study	Number of patients	Dexamethasone treatment group		Prednisone treatment group		6-Month response (dexamethasone vs prednisone)
Study	Number of patients	Dexamethasone regimen*	Prednisone equivalent†	Prednisone regimen*	Prednisone equivalent†	6-Month response (dexamethasone vs prednisone)
Wei et al, 2016⁴³	192	40 mg/day × 4 d for 1-2 cycles	14.2 mg/kg per cycle	1 mg/kg per day for 28 d	28 mg/kg	40.0% vs 41.2% (P = 0.884); platelet count >30 × 10⁹/L with an absence of bleeding and no additional treatment
Bae et al, 2010⁴⁴	151	40 mg/day × 4 d for 1-2 cycles	14.2 mg/kg per cycle	1 mg/kg per day for 28 d	28 mg/kg	33.3% vs 45.0% (P = 0.33); platelet count >30 × 10⁹/L
Din et al, 2015⁴⁵	94	40 mg/day × 4 d for 3 cycles with maintenance 0.035 mg/kg/day dexamethasone between cycles (n = 30) or without maintenance (n = 31)	42.8 mg/kg	1 mg/kg per day for 28 d	28 mg/kg	74.1% with maintenance (P < .05) vs 60% without maintenance vs 58.8%; platelet count ≥30 × 10⁹/L and at least double baseline without bleeding
Mashhadi et al, 2012⁴⁶	60	40 mg/day × 4 d for 1 cycle‡	14.2 mg/kg	1 mg/kg per day for 28 d	28 mg/kg	90% vs 53.3% (P ≤ 0.0001); platelet count ≥30 × 10⁹/L

Study	Number of patients	Dexamethasone treatment group		Prednisone treatment group		6-Month response (dexamethasone vs prednisone)
Study	Number of patients	Dexamethasone regimen*	Prednisone equivalent†	Prednisone regimen*	Prednisone equivalent†	6-Month response (dexamethasone vs prednisone)
Wei et al, 2016⁴³	192	40 mg/day × 4 d for 1-2 cycles	14.2 mg/kg per cycle	1 mg/kg per day for 28 d	28 mg/kg	40.0% vs 41.2% (P = 0.884); platelet count >30 × 10⁹/L with an absence of bleeding and no additional treatment
Bae et al, 2010⁴⁴	151	40 mg/day × 4 d for 1-2 cycles	14.2 mg/kg per cycle	1 mg/kg per day for 28 d	28 mg/kg	33.3% vs 45.0% (P = 0.33); platelet count >30 × 10⁹/L
Din et al, 2015⁴⁵	94	40 mg/day × 4 d for 3 cycles with maintenance 0.035 mg/kg/day dexamethasone between cycles (n = 30) or without maintenance (n = 31)	42.8 mg/kg	1 mg/kg per day for 28 d	28 mg/kg	74.1% with maintenance (P < .05) vs 60% without maintenance vs 58.8%; platelet count ≥30 × 10⁹/L and at least double baseline without bleeding
Mashhadi et al, 2012⁴⁶	60	40 mg/day × 4 d for 1 cycle‡	14.2 mg/kg	1 mg/kg per day for 28 d	28 mg/kg	90% vs 53.3% (P ≤ 0.0001); platelet count ≥30 × 10⁹/L

Adapted from Mithoowani et al.¹¹

Dosing does not reflect therapy tapers, which were often not specified.

Prednisone dose equivalent based on 0.75:5 equivalency ratio and estimated on a 70-kg patient.

Followed by a prednisone taper.