Danazol for the Treatment of Refractory Autoimmune Thrombocytopenia in Systemic Lupus Erythematosus

Sterling G. West, STEVEN C. JOHNSON
In: Annals of Internal Medicine · 1988 · vol. 108(5) , pp. 703–706 · doi:10.7326/0003-4819-108-5-703 · PMID:3358571 · W2065859996
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This noncontrolled trial found that danazol therapy normalized platelet counts in six patients with systemic lupus erythematosus and severe autoimmune thrombocytopenia refractory to other treatments.

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Abstract

STUDY OBJECTIVE: to determine the efficacy of danazol therapy in patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to other therapies. DESIGN: noncontrolled clinical trial, with a minimum of 8 weeks of therapy, the maximum determined by clinical response. SETTING: referral-based rheumatology clinic at an army medical center. PATIENTS: sequential sample of six patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to high-dose glucocorticoids. Four patients also failed splenectomy, or cytotoxic drugs, or both. INTERVENTIONS: danazol, 200 mg four times per day, was added to the previous therapeutic regimen for at least 2 months. MEASUREMENTS AND MAIN RESULTS: all six patients had normal platelet counts within 6 weeks of starting danazol treatment. After resolution of thrombocytopenia for at least 1 month, immunosuppressive medications were tapered; one patient had a relapse. During an average follow-up of 12 months, the danazol dose was lowered in the five remaining patients but could not be discontinued without recurrence of thrombocytopenia. During danazol therapy, platelet-bound IgG antibodies and circulating immune complexes did not decrease significantly. Danazol was well tolerated. CONCLUSIONS: danazol appears to be a useful adjunctive treatment for refractory autoimmune thrombocytopenia associated with systemic lupus erythematosus.

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