ITP Treatments

Treatment

How it Works

Main Side Effects

Steroid
(Prednisolone, Methylprednisolone, Dexamethasone)

Administered Orally

Suppress immune system; decrease platelet destruction

Short-term: Common: irritability, anxiety, insomnia
Rarely: gut bleeding, disseminated chickenpox (if recent contact and
non-immune) Longer-term: Common: weight gain, muscle weakness, bone
loss, visual problems, increased risk for infection Rarely: diabetes,
cataracts

Tavlesse

(Fostamatinib)

Administered Orally

‘Fostamatinib reduces

antibody mediated destruction of platelets.’

Very common adverse events include: dizziness,
hypertension, diarrhoea, nausea and frequent bowel movements. Common adverse events include: upper respiratory tract infection, respiratory tract infection, bronchitis, lower
respiratory tract infection, viral upper respiratory tract infection, neutropenia, febrile
neutropenia, dysgeusia, headache, diarrhoea, abdominal pain upper, abdominal pain, rash,
rash erythematous, rash macular, chest pain, fatigue and influenza like illness. Uncommon
adverse events include: pneumonia and hypertensive crisis

Doptelet
(Avatrombopag)

Administered Orally

Doptelet is used to treat adults
with low platelet counts due to primary chronic immune thrombocytopenia
(ITP)
when a prior treatment for ITP (such as corticosteroids or
immunoglobulins) has
not worked well enough.
Doptelet works by helping to increase the number of platelets in the
blood.
Platelets are blood cells that help the blood to clot and so reduce or
prevent
bleeding.

Feeling tired
Low red blood cell count (anaemia)
Blood clot in the portal vein (blood vessel that carries blood to the
liver from
the intestines) which may result in upper abdominal pain or swelling
Bone pain
Muscle aches
Fever
Decreased appetite
Weakness
Nose bleeds
Skin rash, itching, acne, red spots on skin
Feeling of tingling, prickling or numbness, commonly called “pins and
needles”

Intravenous Immunoglobulin
(Ivig)

Administered Intravenously

Block platelet destruction

Common: fever, chills, headache Rarely: meningitis-like
reaction

Anti-D

Administered Intravenously

Block platelet destruction in the spleen

Common: fever, chills, headache, mild haemolysis Rarely:
severe haemolysis

Rituximab

Administered Intravenously

Suppress immune system; decrease platelet destruction

Common: Fever, chills, rash with infusion. Possible
increased risk for infection Rarely: may cause severe allergic reaction,
late allergic arthritis or kidney failure

Splenectomy

Surgery

Remove the major site of platelet destruction

Surgical complications in 10%, death in 0.2-1 %,
treatment failure in 33%. Long-term: increased risk for infection and
thrombosis (heart attack, stroke, lung disease)

Danazol

Administered Orally

Suppress immune system; decrease platelet destruction

In women: male pattern hair growth. In all patients:
liver function abnormalities

Dapsone

Administered Orally

Unknown

Anaemia; skin rash

Azathioprine

Administered Orally

Suppress immune system; decrease platelet destruction

Increased risk for infection

Cyclophosphamide

Administered Intravenously

Suppress immune system; decrease platelet destruction

Increased risk for infection, urinary bladder
inflammation, hair loss, possible infertility in men and women

Vincristine or Vinblastine

Administered Intravenously

Suppress immune system; decrease platelet destruction

Hair loss, muscle pain, neuropathy (numbness, weakness of
arms and legs), increased risk for infection

Mycophenolate

Administered Orally

Suppress immune system; decrease platelet destruction

Nausea, diarrhoea; increased risk for infection

Plasmapheresis

Intravenous Blood Filtration

Removal of antibodies from blood

None. May need surgical line to be inserted with risk of
local infection or thrombosis (yes even in ITP!)

Cyclosporine

Administered Orally

Suppress immune system; decrease platelet destruction

Tremor, impaired kidney function; high blood pressure,
increased risk for infection Increased hair growth

Nplate (Romiplostim)

Administered Subcutaneously

Stimulate platelet production

No important side effects recognized in current clinical
trials. Rare patients developed marrow fibrosis in early studies with
higher doses than currently allowed

Eltrombopag
Called Revolade in the UK, Promacta in the USA

Administered Orally

Stimulate platelet production

Abnormal loss of
weight; alopecia; anaemia; anxiety; appetite abnormal; arthralgia; asthenia; cataract; chest
discomfort; chills; concentration
impaired; confusion; constipation; cough; depression; diarrhoea; dizziness; drowsiness; dry
eye; dry mouth; dysphagia; dyspnoea; eye discomfort; eye
disorders; fever; gastrointestinal discomfort; gastrointestinal
disorders; haemolytic anaemia; haemorrhage; headaches; hepatic
disorders; hyperbilirubinaemia; hyperglycaemia; hypoglycaemia; increased
risk of infection; influenza like illness; iron overload; lymphopenia; malaise; memory
loss; menorrhagia; mood altered; muscle complaints; nasal
complaints; nausea; neutropenia; oedema; oral disorders; oropharyngeal
complaints; pain; palpitations; QT interval prolongation; sensation
abnormal; skin reactions; sleep disorders; splenic infarction; sweat
changes; syncope; taste altered; urine discolouration; vertigo; vision
disorders; vomiting; weight decreased

Helicobacter Pylori Treatment

Administered Orally

Eradication may remove a stimulus for ITP

Allergic reactions to the medicines (rare)

Vitamin C Supplements

Administered Orally

Unknown

Potential increased risk for kidney stones with high
doses

Platelet Transfusion

Administered Intravenously

Platelet supplementation (transient response as
antibodies may clear donated platelets within minutes- usually reserved
for life-threatening bleeds in conjunction with other therapy)

Fever, chills (uncommon); transfusion- transmitted
infection (very rare)

Tranexamic Acid

Administered Orally

Used to aid clotting

Nausea, diarrhoea, vomiting, disturbance of colour vision