Immune Thrombocytopenic Purpura

Question 1

What is ITP?

Answer 1

Blood disorder characterized by a decrease in the number of platelets in the blood due to autoimmune destruction; may be triggered by infection eg HIV, hepatitis, H.pylori; a lifelong condition for most patients

May present as bruising and bleeding

Question 2

In adults with immune thrombocytopenic purpura, initial treatment is usually with a ________________

Answer 2

corticosteroid, such as prednisolone

Question 3

Intravenous _______________ may be appropriate in patients with immune thrombocytopenic purpura who are bleeding or at high-risk of bleeding, who require a surgical procedure, or who are unresponsive to corticosteroids

Answer 3

normal immunoglobulin, or intravenous anti-D (Rh0) immunoglobulin [unlicensed use]

• Immunoglobulin preparations may also be considered where a temporary rapid rise in platelets is needed, for example in pregnancy

Question 4

Treatment options for persistent or chronic immune thrombocytopenic purpura include _________________, ________________, or _____________

Answer 4

thrombopoietin receptor agonists (avatrombopag, eltrombopag, and romiplostim)

rituximab [unlicensed use]

fostamatinib

• Other therapies that have been tried in refractory immune thrombocytopenic purpura include: azathioprine, ciclosporin, cyclophosphamide, danazol, dapsone, mycophenolate mofetil, and vincristine sulfate

Question 5

Avatrombopag, eltrombopag, and romiplostim are _______________ used in the treatment of persistent or chronic ITP

Answer 5

Thrombopoietin receptor agonists

Question 6

________________ can be considered as a treatment option for ITP only if drug therapy has failed; the patients age and co-morbidities should also be taken into account

Answer 6

Splenectomy