Patients with immune thrombocytopenia (ITP) who have lower levels of platelets and lower mean platelet volume seem less responsive to standard-dose methylprednisolone (methyl-Pd) treatment, found a new study published in the Medeniyet Medical Journal

“It may be more appropriate to apply more effective treatments to these patients other than standard-dose methyl-Pd alone,” the researchers wrote.

Read more about the different types of ITP

Methyl-Pd is used as the main first-line treatment of patients with ITP. However, almost half (40%) of patients do not respond to this treatment, the study team noted.

To determine factors that may predict the response of patients to methyl-Pd, a team of Turkish researchers conducted a study on 144 patients with primary ITP who were treated with standard-dose methyl-Pd. 

The results showed that of these 144 patients, a third (33%) did not respond to standard-dose methyl-Pd, while 28% responded partially. The percentage of patients who showed a complete response to treatment was 39%. 

The mean platelet level of patients who did not respond to treatment was lower than that of patients who responded or responded partially. 

Similarly, the mean platelet volume levels of patients who did not respond to the standard-dose methyl-Pd treatment were also statistically lower than that of patients who showed a complete response to treatment. 

The researchers calculated with 98.1% sensitivity and 45% specificity that the probability of an early response to methyl-Pd was higher in the case of a mean platelet volume of 10 fL or higher and a platelet count of more than 12,000/mm³. The positive predictive value was 82.3%, and the negative predictive value was 90%.

ITP is a rare bleeding disorder characterized by a very low platelet count, often below 100,000/µL leading to symptoms such as petechiae, purpura, ecchymoses, nosebleeds, mucosal bleeding, and hematuria.


Kilicaslan E, Yildirim M, Sayin S, Cevik E, Ayli M, Kaptan M. The effect of platelet and mean platelet volume levels on standard-dose methylprednisolone treatment response in primary immune thrombocytopenia. Medeni Med J. Published online March 10, 2023. doi:10.4274/MMJ.galenos.2023.85520