Proposal for a New Protocol for the Management of Immune Thrombocytopenia (ITP)

Abstract

For many decades immune thrombocytopenia (ITP) was managed using therapies which had not undergone randomised clinical trials and included corticosteroids, immune suppression or splenectomy. These older therapies are associated with an increase in morbidity and mortality. These empirical therapies have variable efficacy and well-described side effects for many patients with minimal benefit to the patient. Over the past 10 years there has been a shift away from immune suppression and non-evidence-based therapies towards using treatments with reduced or no immune suppression with an increasing reliance on the recently developed and approved thrombopoietin receptor agonists. The recent COVID-19 pandemic has made it more urgent that we develop non-immune suppressive strategies for ITP. In this commentary we describe our proposal for a contemporary approach to the management of ITP in adults that is based on our hospital practices and published guidelines.

Recent advances in the management of immune thrombocytopenic purpura (ITP): A comprehensive review

“…TPO-RAs offer a safer and more effective way to manage this condition. [45] In a study conducted in 2020, a thrombopoietin receptor agonist (TPO-RA) was approved for the treatment of immune thrombocytopenia. The number of patients was studied for a short period of time with a therapy of (TPO-RA) and it was concluded that they have a significant effect on ITP and are safe compared to surgical options.…”