Efficacy and safety of dapsone in adult immune thrombocytopenia: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune condition often managed with corticosteroids, intravenous immunoglobulins, or thrombopoietin receptor agonists. In settings where these therapies are inaccessible or contraindicated, dapsone an older antimicrobial agent with immunomodulatory effects has been proposed as an alternative, though its comparative effectiveness and safety profile remain inadequately defined. OBJECTIVES: This study systematically reviews and synthesizes existing data to assess the efficacy and tolerability of dapsone in adult patients with ITP. METHODS: Following PRISMA guidelines, a literature search across PubMed, Embase, and Cochrane databases identified observational studies and interventional trials evaluating dapsone in ITP, including comparisons with standard treatments. Primary outcomes included complete and overall response rates, hemoglobin variation, relapse frequency, and adverse effects. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane tools. Meta-analysis was conducted using RevMan and R (meta/metafor). RESULTS: Four eligible studies encompassing over 270 patients were analyzed. The pooled complete response rate was 28%, while the overall response rate reached 47%. Dapsone use was associated with a modest decline in hemoglobin levels with a mean decrease of 1.74 g/dL, and relapse occurred in approximately 21% of patients. Adverse effects most commonly hemolytic anemia and methemoglobinemia were reported in 18% of patients, though generally not severe. Heterogeneity was explored through leave-one-out sensitivity analyses. CONCLUSIONS: Dapsone demonstrates moderate efficacy and an acceptable safety profile in adult ITP patients, especially in resource-limited contexts. While it may not match thrombopoietin agonists in preventing relapse, its low cost and oral administration offer practical advantages. Further large-scale randomized trials are warranted to clarify its role in ITP management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".