What evolving treatments are available for chronic immune thrombocytopenia (ITP) in adults?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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A number of treatments have been proposed for patients in whom splenectomy and steroid therapy have failed. Most of these treatments are not based on placebo-controlled studies, and evaluating their efficacy in a disease associated with spontaneous remissions and relapse is difficult.

The anabolic steroid danazol (400-800 mg/d) has been shown to induce remission in certain patients. Cyclosporine and alfa-interferon have also been used. Plasmapheresis and extracorporeal protein A adsorption have been tried in desperate situations. The autoantibodies responsible for ITP are primarily IgG, and plasmapheresis is of limited value because more than half of the normal IgG pool is in the extravascular space.

Other evolving therapies for refractory ITP include autologous hematopoietic stem cell transplantation and anticytokine therapy with etanercept.

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