High-dose Cepharanthin for pediatric chronic immune thrombocytopenia in Japan

Pediatr Int. 2017 Mar;59(3):303-308. doi: 10.1111/ped.13151. Epub 2016 Nov 13.

Abstract

Background: A nationwide, multicenter and observational study was retrospectively conducted to evaluate the clinical utility of Cepharanthin (CEP) for pediatric patients with chronic immune thrombocytopenia (ITP).

Methods: Clinical and laboratory data for 46 Japanese patients aged <16 years who were diagnosed as having chronic ITP in 14 hospitals during 2001-2011, and were treated with CEP for >12 months, were analyzed.

Results: Median daily CEP dose was 1 mg/kg (range, 0.12-2 mg/kg). Median platelet count prior to CEP was 20.5 × 109 /L (IQR, 8.3-53.0 × 109 /L), and then significantly increased to 58.5 × 109 /L (IQR, 22.8-115.0 × 109 /L) and 69.0 × 109 /L (IQR, 23.0-134.0 × 109 /L) at 12 and 24 months of treatment, respectively. No life-threatening bleeds or moderate-severe adverse events were reported. Of 38 patients who received both corticosteroids (CS) and CEP, 17 patients (45%) were weaned from CS, and 15 patients (39%) attained the reduced dose of CS. The duration from the start of CEP to the stopping of CS was a median of 413 days (range, 49-1734 days) in patients who were weaned from CS.

Conclusions: CEP alone or combined with CS was useful for the management of pediatric chronic ITPs.

Keywords: Cepharanthin; child; corticosteroid; idiopathic thrombocytopenic purpura; platelet count.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Benzylisoquinolines / therapeutic use*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Drug Administration Schedule
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Japan
  • Male
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Benzylisoquinolines
  • cepharanthine