New article abt Dex and Rituxan

Dexamethasone plus rituximab yields higher sustained response rates than dexamethasone monotherapy in adults with primary immune thrombocytopenia
Francesco Zaja, Michele Baccarani, Patrizio Mazza, Monica Bocchia, Luigi Gugliotta, Alfonso Zaccaria, Nicola Vianelli, Marzia Defina, Alessia Tieghi, Sergio Amadori, Selenia Campagna, Felicetto Ferrara, Emanuele Angelucci, Emilio Usala, Silvia Cantoni, Giuseppe Visani, Antonella Fornaro, Rita Rizzi, Valerio De Stefano, Francesco Casulli, Marta Lisa Battista, Miriam Isola, Franca Soldano, Enrica Gamba, and Renato Fanin
Blood published 3 February 2010, 10.1182/blood-2009-07-229815

bloodjournal.hematologylibrary.org/cgi/content/abstract/blood-2009-07-229815v1

Abstract

Previous observational studies suggest that rituximab may be useful in the treatment of primary immune thrombocytopenia (ITP). This randomized trial investigated rituximab efficacy in previously untreated adult ITP patients with a platelet count 20 x 109/L. One hundred and three patients were randomly assigned to receive 40 mg/day dexamethasone for 4 days with or without 375 mg/m2 rituximab weekly for 4 weeks. Patients refractory to dexamethasone alone received salvage therapy with dexamethasone plus rituximab. Sustained response (i.e. platelet count 50 x 109/L at Month 6 after treatment initiation), evaluable in 101 patients, was higher in patients treated with dexamethasone plus rituximab (n=49) than in those treated with dexamethasone alone (n=52) (63% vs. 36 %, P= 0.004, 95% C.I.: [0.079-0.455]. Patients in the experimental arm showed increased incidences of grade 3-4 adverse events (10% vs. 2%, P=0.082, 95% C.I.: [-0.010-0.175]), but incidences of serious adverse events were similar in both arms (6% vs. 2%, P=0.284, 95% C.I.: [-0.035-0.119]). Dexamethasone plus rituximab was an effective salvage therapy in 56% of patients refractory to dexamethasone. The combination of dexamethasone and rituximab improved platelet counts compared to dexamethasone alone. Thus, combination therapy may represent an effective treatment option before splenectomy. This study was registered at clinicaltrials.gov as NCT00770562 [ClinicalTrials.gov] .

Erica (who needs to create a sig file)

I don't quite understand (from the abstract) whether the combo treatment is in any way better than rituxan without dex. It says it is better than dex without rituxan.
Erica

For some reason my Dr has always given my Dex with Rituxan. We've sliced the dosage several times, and Dex alone never worked for me but I'm always given Dex, Tylonol, and Benedryl as pre-treatment everytime I get Rituxan