Combination therapy effective in the treatment of relapsed immune thrombocytopenia in adults (72% had complete response with platelets in seven days)

Medical Xpress / Frontiers Journals / Global Medical Genetics ^ | Oct. 10, 2023 | Lijun Fang et al

[ConservativeMind]

In the treatment of immune thrombocytopenia (ITP), glucocorticoids and IVIg are considered the primary therapeutic options. Typically, clinicians opt for either of these treatments when addressing ITP cases.

A new study used a multicenter comprehensive retrospective analysis to assess the effectiveness and safety of primary single-agent and combination therapies in treating adult patients with relapsed immune thrombocytopenia (ITP). It represents the first attempt to compare the effectiveness of three treatment modalities (IVIg, glucocorticoids, or a combination of both) in enhancing platelet counts among adult relapsed ITP patients.

Professor Zhang Lei said, "Our study unveiled a remarkable finding: the combination therapy of IVIg and glucocorticoids in treating adult relapsed ITP patients led to a complete response (CR) rate of 71.83% within seven days, outperforming the IVIg group (43.48%) and the glucocorticoid group (23.08%). Moreover, the rate of improvement in platelet count and the daily proportions reaching 30×109/L, 50×109/L, and 100×109/L in the combination therapy group significantly differed from those in each single-agent group.

"Therefore, for relapsed persistent and chronic ITP patients, especially those requiring a rapid increase in platelet levels, relying solely on glucocorticoid medication might not be the most effective strategy. Combining IVIg to achieve superior efficacy is advisable.

"Our findings indicate that for relapsed persistent and chronic ITP patients, the combination therapy approach involving first-line drugs offers advantages in both onset time and treatment efficacy. This rapid, stable, and high CR rate clinical efficacy is particularly beneficial for patients with low platelet counts and accompanying bleeding symptoms. Combination therapy can safely and effectively elevate platelet counts swiftly, achieving hemostasis and reducing the necessity for platelet transfusions."

[ConservativeMind]

If you have this platelet condition, opt for both medicines, for the quickest, most satisfactory, outcome.

[ConservativeMind]

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[mistfree]

ITP is caused by antibodies that the patient produces against platelets. The article states that their treatment “ reducing the necessity for platelet transfusions.” Transfusing platelets to these patients is not only ineffective but counterproductive because it stimulates the production of additional antibodies that destroy platelets. The combination therapy sounds good but how long does it last? Most patients with relapsing ITP end up with a splenectomy which will alleviate the platelet shortage in the body.

[momincombatboots]

Wonder if it works for vaccine induced thrombocytopenia.

[brianr10]

I had ITP 10 years ago. Steroids and IVg didn’t work. Put me on Promacta, which worked, then weaned off it.

[mistfree]

I’m glad it worked. Stay healthy.