Efficacy and safety of rituximab as second-line therapy in immune thrombocytopenic purpura based on ethnicity: A descriptive study among the Arabic population

Abstract

Background: Rituximab is used as second-line therapy in patients with immune thrombocytopenic purpura (ITP) who do not respond to first-line management. The response rate for Rituximab is variable in different populations ranging from 30% to 90%. The adverse effects of rituximab in patients with ITP range from infusion site reactions to the reactivation of hepatitis B virus and progressive multifocal leukoencephalopathy and interpopulation variation. Methods: We conducted a single-center, retrospective study in Qatar's National Center for Cancer Care & Research. The study included patients with chronic refractory ITP who received rituximab as second-line therapy. Descriptive and summary statistics were used to describe the sociodemographic parameters of the study cohort. Results: Of the 41 patients with chronic ITP, 26 were Arabs, 12 were Asians, and 3 were of other ethnicities. Rituximab was associated with an overall response rate of 80.4%. Arabic patients had the highest clinical response (84.6%) among the ethnicities with the lowest adverse effects (11.5%). Asians had a response rate of 66.6%, and adverse effects were seen in 16.7% of the patients. Conclusions: In chronic refractory ITP, rituximab appears to have a better clinical response in the Arabic population with minimal toxicity than in other ethnicities.

A Challenging Case of a Patient With Immune Thrombocytopenic Purpura on Eltrombopag Who Developed Atrial Fibrillation: An Anticoagulation Dilemma

“…Hence, clinical follow-up of patients is crucial with frequent questions about bleeding/thrombosis symptoms and signs. In one study, the most common adverse events were anemia, upper respiratory tract infection, and cough, hence, it is advisable to ask patients about these symptoms [12][13][14].…”

Omicron-Induced Immune Thrombocytopenia: A Case Report

“…We used IVIG and glucocorticoids together because each has a unique mode of action and can be additive, although no direct trials have been recorded. Splenectomy, rituximab [ 12 ], or a thrombopoietin receptor agonist (TPO-RA) [ 13 ] are the three top choices for second-line treatment. All three are effective in raising the platelet count in most individuals.…”