title: Current treatment options for primary immune thrombocytopenia.
abstract: Traditional treatment of primary (idiopathic) immune thrombocytopenia (ITP) predominantly consists of immune suppression and/or modulation. In addition, many treated patients develop severe adverse effects, and approximately a third of patients do not respond. Two of the newly developed thrombopoietin-receptor agonists, romiplostim and eltrombopag, are now available for the treatment of ITP. Both drugs have been shown to increase the production of platelets in a dose-dependent manner, and to compensate, at least partly, for thrombocytopenia in the majority of ITP patients. The reported adverse effects are predominantly mild, although serious and long-term side effects cannot be excluded. Nevertheless, these drugs are increasingly used in the treatment of patients with thrombocytopenias. Thrombopoietin-receptor agonists do not appear to stop either the production of autoantibodies or the accelerated platelet destruction observed in ITP. Thus, the need for a specific therapy is essential, and the ultimate solution is to clarify and halt the mechanism(s) that lead to the development of ITP.
authors.affiliation: Institut für Transfusionsmedizin, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany. abdulgabar.salama@charite.de
authors.forename: Abdulgabar
authors.initials: A
authors.lastname: Salama
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007518:Isoantibodies / Q000276:immunology / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011961:Receptors, Fc / Q000627:therapeutic use; D053628:Receptors, Thrombopoietin / Q000819:agonists / Q000378:metabolism; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D018029:Rho(D) Immune Globulin; D000069283:Rituximab; D013921:Thrombocytopenia / Q000188:drug therapy*; D013926:Thrombopoietin / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D001565:Benzoates; D006834:Hydrazines; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; D011720:Pyrazoles; C061961:RHO(D) antibody; D011961:Receptors, Fc; D053628:Receptors, Thrombopoietin; D011993:Recombinant Fusion Proteins; D018029:Rho(D) Immune Globulin; D000069283:Rituximab; D013926:Thrombopoietin; C488777:romiplostim; D001379:Azathioprine; C520809:eltrombopag