Glucocorticoids promote response to thrombopoietin-receptor agonists in refractory ITP: a case series
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A proportion of patients with immune thrombocytopenic purpura are refractory to multiple therapies including thrombopoietin-receptor agonists (TPO-RA). We report 10 patients who did not respond to a TPO-RA until the addition of a glucocorticoid. These patients were previously treated with a median of 6 therapies. One patient elected to discontinue both medications despite persistent thrombocytopenia. The remaining 9 patients continued on the combination of prednisone (doses 5 mg every other day to 10 mg daily) and a TPO-RA. Combination therapy with low dose glucocorticoid and a TPO-RA may be an option for patients unresponsive to a TPO-RA alone.
KeywordsAutoimmune thrombocytopenia Immune thrombocytopenic purpura Refractory Thrombopoietin-receptor agonists Glucocorticoids
Jacqueline N. Poston receives support from an Institutional Training Grant from the National Heart, Lung, and Blood Institute (T32 HL007093).
JNP and TBG co-wrote the manuscript. JNP analyzed the data.
Compliance with ethical standards
Conflict of interest
Jacqueline N. Poston has no conflicts of interest to disclose. Terry B. Gernsheimer has been a consultant for Amgen and Novartis.
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