Understanding ITP

What is ITP?

Immune thrombocytopenia (ITP, also known as immune thrombocytopenic purpura) is a rare blood condition. People who have ITP do not have enough platelets in their blood. Platelets are blood cells that help stop bruising and bleeding when you get hurt. This low number of platelets can lead to easy bruising and bleeding.

 

Even though it may be scary to be diagnosed with ITP, there is good news:

  • It’s not cancer
  • It’s not contagious
  • It’s often managed with treatment

In what ways can ITP affect me?

  • Your body may be destroying healthy platelets
  • Your body doesn’t make enough platelets
  • You may experience common symptoms such as: bruising, prolonged bleeding from wounds, visible red or purple dots (petechiae), spontaneous nosebleeds, bleeding gums, blood in urine or stools, unusually heavy menstrual flow, and feeling tired or fatigued

Promacta Circulating Platelets

What are the different types of ITP?

ITP can be divided into 3 types, named according to how long it lasts after diagnosis. The time since diagnosis is often a factor in treatment decisions.

 

Newly diagnosed ITP

When you are first diagnosed with ITP, your doctor may also refer to it as acute ITP, meaning you have had it less than 3 months and it may resolve with initial treatment. They may prescribe a treatment to get platelets up quickly, such as steroids or intravenous immunoglobulin (IVIg).

 

Persistent ITP

ITP that lasts 3-12 months after diagnosis is called persistent ITP. Your doctor may want to try a new treatment option with proven effectiveness in persistent ITP.

 

Chronic ITP

If your ITP lasts >12 months after diagnosis, it is called chronic ITP. It’s important to discuss treatment options with your doctor to find an effective treatment that fits your lifestyle.

 

If you live with this condition, you may have seen your platelets rise with earlier ITP treatments, only to be disappointed when they fell again once treatment was stopped.

 

PROMACTA® (eltrombopag) is a prescription treatment for people with persistent or chronic ITP. It may help boost platelets and maintain stable platelet counts after other treatments have not worked well enough or have caused too many side effects.

 

Below are other ITP treatments you may come across as you learn about and explore different treatment options.

Common ITP treatments

Newly diagnosed ITP
(sometimes called acute ITP)

Corticosteroids (steroids)

Most ITP patients start with a round of steroids to stop the body from destroying platelets and quickly raise platelet counts. Unfortunately, steroids can also have side effects, such as insomnia, weight gain, and mood changes. That’s one of the reasons why the American Society of Hematology (ASH) recommends the use of steroids for no more than 6 weeks.

 

Intravenous immunoglobulin (IVIg)

IVIg is also an option to raise platelet counts quickly. IVIg is an infusion given with a needle and requires sitting still for some time in an infusion center while the medicine goes into the veins.

Persistent or chronic ITP
(lasting ≥3 months despite treatment)

Thrombopoietin receptor agonists (TPO-RAs)

Instead of trying to stop the body from destroying platelets, TPO-RAs are platelet boosters that encourage the body to make more. ASH recommends the use of TPO-RAs before other treatments for persistent or chronic ITP (see below). Currently, there are 2 TPO-RAs in the ASH guidelines:

  • Nplate® (romiplostim) is an injection that requires a weekly doctor visit to receive treatment. It is approved for adults and children >1 year old
  • PROMACTA® (eltrombopag) is a once-daily oral treatment taken wherever and whenever it works for you. It comes in both tablets and oral suspension and is approved for adults and children >1 year old

 

Kinase inhibitors

Tavalisse® (fostamatinib disodium hexahydrate) is a medicine that blocks the action of an enzyme involved in platelet destruction. It is approved for use in adults with chronic ITP, but is not yet part of the ASH guidelines.

 

Monoclonal antibodies

Rituxan® (rituximab) is a monoclonal antibody that suppresses a specific target in the immune system. While part of the ASH guidelines, it is not a US Food and Drug Administration (FDA)-approved treatment for persistent or chronic ITP.

 

Splenectomy

A splenectomy is surgery to remove the spleen. While doctors would not normally remove a healthy organ, taking it out can help some people with persistent or chronic ITP. However, there is no test to show whether or not a splenectomy will work, and there is always a risk with any surgical procedure.

Nplate is a registered trademark of Amgen Inc. Rituxan is a registered trademark of Biogen. Tavalisse is a registered trademark of Rigel Pharmaceuticals, Inc.