next step after prednisone?

if a person responds well to prednisone, in that numbers increase as prednisone increases, as i do, what would be a logical next step? in your experience, if prednisone worked, what other meds have a better chance of working as well?

Rhoda:
You have several choices that you could suggest to your Hemo. Rituxan, Win-Rho, CellCept, Imuran, or one of the TPO's. Any of them have a chance of working and responding to Prednisone doesn't really predict responses to the other meds.

Rhoda, it's been awhile. What is your thinking on a Dex pulse, or have you tried that already? If you're reacting well to steroids, might it be worth a try?

Yea, you would think that science would have figured out what a good next drug should be, but they haven't. It's the same story with IVIG as well.

what is the dosage of prednisone?
What is the platlet count?

If you reduce prednisone does platlets drop?

If a person responds to prednisone then rituximab would be a next good step. (They are using similar methodology, ie. reducing the immune system)
Nplate or Promacta can also be tried but these help out with the production issues and these are cheaper\less time consuming.

i've not been able to get off of prednisone.

i can hang out at 5 mg daily for weeks, even several months, with numbers in the 30's or so. i'm perfectly happy there. life is good. but inevitably, something happens, and i tank down into the single digits. increasing prednisone takes the numbers up quite nicely within a day or so.

the current cycle that i'm on started on march 6. i was quite surprised with results of 7. i wasn't expecting it to be that low. maybe high teens, but not single digits. and so he put my pred up to 60 mg. and in 3 days, numbers were good again. he let me drop down to 40, and redraw on the 13th - was 136. i could start to taper by 5 mg q 3 days, redraw when at 25 mg on the 20th. well, numbers were 93. so he says, stay on 30 mg for a week, and redraw. that redraw will be this monday. and my numbers will be great. and i'll continue on the tapering dosage down to 5 mg and stay there.

the previous cycle with a count of 3, was in october, 2016. prednisone brought my numbers up very nicely, very quickly. prior to that, was in april.

prednisone works. and works nicely. he has suggested nplate, but hasn't pushed anything yet. prednisone is cheap, it works, i don't have to take off work, i can function on it, i have very few nasty side effects (x for the weight gain). that's why i've been reluctant to try other meds with unknown side effects. i'm at the point now tho, where i'm ready to try something else. my next appt is coming up on april 12, and i'm hoping to have done my homework.

rituxan sort of scares me...

humph.
i like 41. 41 is a good number. it's a good place to hang out at.

but not after i've been on pred 30 mg for a week, and the previous number was 93. that's not what i wanted to see today. my numbers should not be going down.

Give it another week or two. Weird things happen sometimes and it's best to look at a trend, not just one count. Hang in there, Rhoda!

oh i'm hanging!!
maybe its the ranitidine i'm taking. i can't figure out what to blame the tanking on, this time. last time i blamed it on the cat bite.

I was on Ranitidine for ages. It didn't seem to affect my count. I have found that I need at least 25mg of Pred now to maintain my counts above 20 which is too much hence my starting on Eltrombopag and tapering my steroids down