What are the International Consensus Report guidelines for ongoing treatment of immune thrombocytopenia (IPT)?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

For subsequent therapy, medications with robust evidence of efficacy are as follows:

  • Rituximab
  • TPO-RAs: eltrombopag, avatrombopag, romiplostim
  • Fostamatinib

Medical therapies with less robust evidence are as follows:

  • Azathioprine
  • Cyclophosphamide
  • Cyclosporine
  • Danazol
  • Dapsone
  • Mycophenolate mofetil (MMF)
  • Switching from one TPO-RA to another
  • Vinca alkaloids

​Consensus-based recommendations for target platelet counts (× 109/L) for dental procedures in adults are as follows:

  • Dental prophylaxis (descaling, deep cleaning):  ≥20 to 30
  • Simple extractions:  ≥30
  • Complex extractions:  ≥50
  • Regional dental block: ≥30  

Consensus-based recommendations for target platelet counts (× 109/L) for surgery in adults are as follows:

  • Minor surgery: ≥50 
  • Major surgery: ≥80
  • Major neurosurgery: ≥100

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