<qa>  What is the primary endpoint of remission defined as?Patients above the age of 18 years with a first episode of immune thrombocytopenia ITP are eligible for inclusion, except pregnant women and patients unable to tolerate glucocorticoids. Diagnosis is made and treatment requirement defined according to the 1996 practice guidelines of the American Society of Hematology. The primary endpoint is duration of remission defined as platelets 50nl. Secondary endpoints are response rate, complete remission platelets 150nl, cumulative cortisol equivalent dose potency of prednisone dexamethasone relative to cortisol: x 4 x 30 and adverse events. During the first week of treatment all patients receive prednisone at 1 mgkgd. This period is used to confirm the diagnosis and identify patients with ITP secondary to lymphoproliferative, autoimmune systemic lupus erythematosus, antiphospholipid syndrome or infectious diseases human immunodeficiency, hepatitis C, cytomegalovirus infection. Patients are stratified by age cut-off: 50 years, gender and primary versus secondary ITP and then randomized 1:1 between daily prednisone arm A and pulsed dexamethasone arm B. In arm A prednisone is continued at 1 mgkgd for a second week. If platelets increase to 50nl, its dose is reduced to 25 mgd by week 14 and 7.5 mgd by week 20 according to a step-wise reduction scheme provided in the protocol. In patients without response after 2 weeks of treatment, the prednisone dose is increased to 2 mgkgd for another 2 weeks, then tapered as described above. In arm B patients receive six 21-day courses of pulsed dexamethasone 0.6 mgkgd, days 1-4. Patients failing to achieve or maintain a remission are switched to the alternative treatment arm A: no response after 4 weeks of prednisone at 1-2 mgkgd, loss of response, maintenance doses exceeding the above limits; B: no response after 2 cycles, loss of response. 