Immune thrombocytopenia

An autoimmune disease with isolated thrombocytopenia (platelets under 100×10⁹/L) from antibody-mediated platelet destruction in the spleen and impaired thrombopoiesis. ASH 2019 and the Spanish SEHH 2023 base therapy in primary ITP: systemic steroids (prednisolone or short-course dexamethasone) – first-line; with inadequate response or relapse – rituximab, thrombopoietin receptor agonists (eltrombopag, romiplostim, avatrombopag), splenectomy.

ICD-10 D69.31 drug

Also known as: Idiopathic thrombocytopenic purpura, ITP

Drugs used for this condition

AEltrombopagSecond line · Thrombopoietin receptor agonist (TPO-R)Second-line for chronic immune thrombocytopenia in adults and children over 1 year after steroid and splenectomy failure or splenectomy contraindication per ASH 2019 and the Spanish SEHH 2023. Adult starting dose 50 mg once daily, titrated to 75 mg daily. RAISE and the EXTEND long-term extension maintained platelets above 50×10⁹/L in 60–80% of patients.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit