Platelet autoantibody specificity and response to rhTPO treatment in patients with primary immune thrombocytopenia

Abstract

Summary This retrospective study aimed to evaluate the relationship between plasma autoantibody species and rhTPO response in adult ITP patients who failed the first‐line treatments. Plasma anti‐glycoprotein (GP) IIb/IIIa and anti‐GPIb/IX autoantibodies were detected in 47·2% and 40·6% of the 123 patients, respectively. Overall response rate to rhTPO treatment in patients without anti‐GPIb/IX autoantibodies was significantly higher than patients with anti‐GPIb/IX autoantibodies (82·2% vs. 60·0%, P = 0·006). By contrast, no statistical difference in response rate was observed between patients with or without anti‐GPIIb/IIIa autoantibodies (74·1% vs. 72·3%, P = 0·819). Therefore, the presence of anti‐GPIb/IX autoantibodies might serve as a predictive factor for poor response to rhTPO treatment in ITP.

A bibliometric analysis of primary immune thrombocytopenia from 2011 to 2021

“…Some biomarkers might be predictive factors for the responses of TPO‐RAs. The presence of anti‐GPIb/IX autoantibodies might indicate poor response to rhTPO treatment in ITP patients 72 . Moreover, the anti‐c‐Mpl antibody might also represent an indicator of poor prognosis and could be a potential therapeutic target in ITP 73 …”

Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment – Recommendations from an Expert Group from Austria, Germany, and Switzerland

“…Approximately 10-20% of patients are relatively unresponsive to IVIG, particularly those with platelet autoantibodies directed against GP Ib/IX. Nevertheless, a trial of IVIG is justified in these, and other patients whose severe bleeding is uncontrolled by other measures [47].…”

Efficacy and safety of treatments in newly diagnosed adult primary immune thrombocytopenia: a systematic review and network meta-analysis

“…rhTPO is a full-length glycosylated TPO, whose bind site is similar to the endogenous TPO. 33 , 34 The median time to response of rhTPO is 4 days, 35 shorter than other treatments and suitable for the emergency treatment of ITP. 34 , 36 In our study, rhTPO plus dexamethasone showed the highest early response.…”