ITP is also known as Idiopathic Thrombocytopenia Purpura
Once a diagnosis of ITP has been reached there are a number of options for treatment. In Australia the individual needs and factors of the patient are taken into account when deciding on the course of action taken. This includes age, mobility and lifestyle.
The initial treatment will normally include Corticosteroids and/or IVIg followed by secondary treatments. These currently include Rituximab, TPORAs (Romiplostim and Eltrombopag) and/or Splenectomy. In Australia, in order to receive government funded (PBS) Romiplostim or Eltrombopag, most people with ITP will need to have splenectomy first, and only if the splenectomy has not been successful will they be able to access these drugs.
Treatments and their effectiveness are as unique as each patient. What works for one patient may not work as effectively as another.
Corticosteroids work by suppressing the immune system to raise the platelet count. Treatment is normally administered in the form of an oral tablet with the dosage determined by your medical professional.
About Intravenous Immunoglobin
Intravenous Immunoglobin Is better known within ITP patients as IVIg. IVIg is a solution of human donated plasma proteins and in particular IgG antibodies with a broad spectrum of antibody activities.
Research indicates that Rituximab has a better response rate in patients that have had ITP for under two years. It has been shown that 50-60% of patients during this timeframe achieve a platelet count of >50 x 109/L.
There are two TPO-RA treatments currently available. These are Romiplostim, which is a TPO-RA Peptibody, and Eltrombopag which is a non-Peptide. So, what is a Thrombopoietin Receptor Agonists or TPO-RA?
Commercially known as Nplate, Romiplostim is known as a peptibody and comes in liquid form and is delivered through regular (usually weekly) subcutaneous injections. This treatment is only available on the PBS to patients who relapse following splenectomy or have contraindications to splenectomy and previously treatment failure.
Eltrombopag, also known as Revolade or Promacta, is a non-peptide molecule which binds to the TPO receptor to increase platelet counts. This treatment is only available on the PBS to patients who relapse following splenectomy or have contraindications to splenectomy and previous treatment failure.
This is a surgical procedure which involves the removal of the spleen. Located underneath the ribcage on the left side, the spleen has several functions which include the filtration of germs and bacteria which may cause infection, storage for extra blood not needed and the removal of old or damaged blood cells, including platelets.