Receiving a diagnosis of immune thrombocytopenia (ITP) often comes with a flood of questions, one of the most pressing being, “Is ITP curable?” This article explores the complexities of ITP, current treatment options, and the ongoing search for a cure.

Building a Foundation: Key Information about ITP

ITP is an autoimmune disorder where the immune system mistakenly destroys platelets or fails to produce enough, leading to a low platelet count. Platelets play a crucial role in blood clotting, so individuals are at a higher risk of bruising and bleeding when their levels drop. The condition varies significantly between individuals – some experience short-term episodes, while others deal with a persistent or chronic form.

ITP can manifest differently, and each individual’s journey through the condition is unique. Understanding its phases and possible outcomes can help people navigate their diagnosis more confidently.

The Different Phases of ITP

Newly Diagnosed or Acute ITP: All patients start in this phase upon diagnosis. In children, a majority will not progress to the future phases; however, this is not necessarily the case in adults. When discussing this phase, healthcare professionals refer to a person within the first three months since diagnosis.
Persistent ITP: If the condition continues for more than six months, their ITP is considered persistent. Some people may see their platelet counts stabilise during this phase, while others may progress to the next phase.
Chronic ITP: A person’s ITP is generally classified as chronic if it lasts for 12 months or more if standard treatment options fail to provide long-term remission. Chronic ITP often requires ongoing management based on the various treatment options available. This can include managing achievable Quality of Life goals, reducing the risk of active and prolonged bleeding episodes and a stabilised platelet count.

Remission

One of the more unpredictable aspects of ITP is that, in some cases, platelet counts can return to normal without treatment and with the assistance of therapy. This phenomenon, known by the ITP community as remission, highlights the dynamic nature of the immune system. While doctors cannot predict who will experience remission, it does provide hope that some individuals may achieve a normal platelet count and reduced symptoms over time.

Treatment Approaches

While there is no cure for ITP, several treatment options help manage symptoms, increase platelet counts and improve overall well-being. These may include corticosteroids, immunosuppressive therapies, intravenous immunoglobulin (IVIG), thrombopoietin receptor agonists (TPO-RAs), and more. For a complete list of recommended treatments and adult and paediatric treatment guidelines, visit ITPAustralia.org.au/patient-resources/

The Quest for a Cure

In the current medical landscape, ITP is considered a chronic condition for which a complete and permanent cure remains elusive. The autoimmune nature of ITP complicates the pursuit of a definitive treatment, as it involves the intricate dynamics of the immune system and platelet destruction and production.

Factors Contributing to the Challenge

Autoimmune Complexity: The autoimmune aspect of ITP involves the immune system mistakenly identifying platelets as foreign invaders and targeting them for destruction. Unravelling the complexities of this immune response and developing interventions that recalibrate the immune system without causing significant side effects is a formidable challenge.
Heterogeneity of ITP: ITP exhibits significant heterogeneity among individuals, with varying clinical presentations and responses to treatments. What works for one person may not be as effective for another, necessitating personalised treatment approaches.
Unknown Triggers: The exact cause of ITP remains unknown in many cases, with idiopathic thrombocytopenic purpura being an earlier term for the disorder, emphasising its mysterious origin. Developing targeted curative interventions becomes more challenging without clearly understanding the triggers.

Hope is on the Horizon

While a definitive cure for ITP remains elusive, ongoing research and medical advancements offer hope for improved outcomes and a better understanding of the disorder.

Biological Therapies: Investigational therapies that target specific pathways in the immune system are being explored. Biologics, including monoclonal antibodies, aim to modulate the immune response more precisely.
Precision Medicine: The field of precision medicine seeks to tailor treatments based on an individual’s specific genetic and molecular characteristics. This approach may lead to more effective and personalised interventions for ITP.
Clinical Trials: Participation in clinical trials provides people living with ITP access to innovative treatments and contributes valuable data to ongoing research efforts. Clinical trials are essential for advancing our understanding of the disorder and testing novel therapeutic approaches. For details on active Clinical Trials across Australia, visit ITPAustralia.org.au/clinicaltrials/
BioBank Initiatives: Research into ITP takes a dedicated investment over a long period of time into collecting samples from patients as they are diagnosed and again at different time points as they recover or relapse after treatment. Using these samples stored carefully over time, researchers can begin to answer critical questions such as how to bring precision medicine to patients with ITP.

Living Well with ITP

While a cure for ITP remains one of the many goals on the horizon, the focus for individuals living with the condition is on effective management and maintaining a good quality of life.

Prioritise Mental and Physical Well-Being: Living with a chronic condition can be emotionally taxing. Managing stress through mindfulness, exercise, or talking with a support group can help you stay resilient. Physical activity, when appropriate, can also support overall health and energy levels. For more information, visit our news section – ITPAustralia.org.au/category/mental-health
Understanding Your Symptoms of ITP: Being in tune with your body can help you recognise changes early. Keep an eye on signs such as increased and spontaneous bruising, prolonged bleeding, petechiae, fatigue, and mucosal blisters. If new symptoms appear or existing ones worsen, discuss them with your healthcare team and seek medical attention.
Monitor Treatment Side Effects: Treatments for ITP come with their own individual side effects. This can include mood swings, moon face, insomnia, diarrhea and other more serious complications. We recommend reviewing the treatment information sheets available at ITPANZ.org.au for many of these treatments and discussing these symptoms or changes with your healthcare professional to discuss ways to reduce these side effects and/or adjust your treatment plan to support your physical and emotional health best.
Stay Informed and Advocate for Yourself: Learning about ITP and available treatment options allows you to make informed decisions and have more productive discussions with your healthcare team. Don’t be afraid to ask questions or seek a second opinion if needed. Learn more about shared decision-making and how to foster an ongoing relationship with your healthcare team by reviewing the shared decision-making toolkit created by the UK ITP Support Association.
Build a Support Network: Connecting with others who understand what you’re going through can provide encouragement and insight. Online and in-person support groups can be valuable resources for shared experiences and coping strategies. View the regular events and join the Private ITP for Aus & NZ Residents Facebook group.

Currently, immune thrombocytopenia is considered a chronic condition without a definitive cure. However, ongoing research, advancements in medical technology, and pursuing innovative therapies hold promise for the future. The landscape of ITP management is evolving, and individuals living with the condition are encouraged to stay informed, participate in clinical trials if suitable, and maintain open communication with their healthcare teams.

While a cure may still be a work in progress, the current focus is on effective management and improving the quality of life for those living with ITP.

Understanding ITP: Is a cure possible, or is management the key?