title: Positioning new treatments in the management of immune thrombocytopenia.
abstract: Immune thrombocytopenia (ITP) is a syndrome characterized by low platelet counts and an increased risk of bleeding. For most children, ITP is a self-limiting disease; however, for some children and most adults, thrombocytopenia can become chronic. Newer therapies for ITP include rituximab and thrombopoietin (TPO) receptor agonists. Rituximab is a useful second-line therapy and may be splenectomy-sparing. Thrombopoeitin receptor agonists have demonstrated large treatment effects with respect to increasing platelet levels; however, they require maintenance dosing. This review summarizes how these new agents might be positioned in the management of patients with chronic ITP.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada. arnold@mcmaster.ca
authors.forename: Donald M
authors.initials: DM
authors.lastname: Arnold
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D001792:Blood Platelets; D002648:Child; D006470:Hemorrhage; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000276:immunology* / Q000628:therapy*; D011720:Pyrazoles / Q000627:therapeutic use; D011961:Receptors, Fc / Q000627:therapeutic use; D053628:Receptors, Thrombopoietin / Q000819:agonists; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D000069283:Rituximab; D034061:Thrombopoiesis / Q000187:drug effects* / Q000276:immunology; D013926:Thrombopoietin / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001565:Benzoates; D006834:Hydrazines; D011720:Pyrazoles; D011961:Receptors, Fc; D053628:Receptors, Thrombopoietin; D011993:Recombinant Fusion Proteins; C082218:MPL protein, human; D000069283:Rituximab; D013926:Thrombopoietin; C488777:romiplostim; C520809:eltrombopag