title: [Clinical statistics and effectiveness of different treatments of idiopathic thrombocytopenic purpura].
abstract: OBJECTIVE
  To ascertain efficacy of modern treatment methods in idiopathic thrombocytopenic purpura (ITP), to characterize basic indications for administration of these methods; perspective trends in ITP therapy.
  
  
  METHODS
  The article presents 20-year experience in observation and treatment of 1000 ITP patients gained from 1988 by the department of standardization of blood disease treatment methods on the basis of a consultative and outpatient department of Hematological Research Center. The results were assessed by conventional ITP treatment lines.
  
  
  RESULTS
  First-line therapy--glucocorticoids--provided remission in 70% patients, long-term (60 months and longer) in 14%, prednisolone resistance was in 19% patients.Intravenous immunoglobulin provided a rapid hemostatic effect (in 1-2 days) in all the patients. A positive response to treatment was seen in 86% patients but it was short-term (for a year and longer in 27%, resistance to the drug--14%). Second line treatment--splenectomy--is the most effective treatment: 80% remission, 32% patients had remission for longer than 60 months. Resistance occurred in 6% patients. Ineffectiveness of treatment in 20% patients stimulated the search for new pathogenetic treatment among synthetic analogues of thrombopoietin. Clinical trials proved high efficacy of two of them--eltrombopag and romiplostim (86-87% response), possible maintenance of remission in long-term interrupted administration of low doses.
  
  
  CONCLUSIONS
  Modern ITP treatment allows a complete management of hemorrhagic syndrome and deep thrombocytopeny in 80% patients with provision of good quality of life and ability to work. Introduction into clinical practice of thrombopoietin analogues improves treatment results including in 20% patients resistant to all treatments in the absence of marked side effects even in long-term 3-year administration of such medication.
authors.forename: L G
authors.initials: LG
authors.lastname: Kovaleva
authors.forename: E I
authors.initials: EI
authors.lastname: Pustovaia
authors.forename: T I
authors.initials: TI
authors.lastname: Safonova
authors.forename: A A
authors.initials: AA
authors.lastname: Riadnenko
authors.forename: E N
authors.initials: EN
authors.lastname: Kolosova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000628:therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors