Chokri Ben Lamine: The Evolving Treatment Landscape of Persistent and Chronic ITP
Chokri Ben Lamine, Hematologist at King Faisal Specialist Hospital and Research Center, shared a post on X:
“Persistent/chronic immune thrombocytopenia (ITP): treatment toolbox.
TPO receptor agonists – romiplostim, eltrombopag, avatrombopag: increase platelet production.
Fostamatinib – SYK inhibitor: reduces immune-mediated platelet destruction.
Rilzabrutinib – oral BTK inhibitor; FDA-approved for adults with persistent/chronic ITP after insufficient response to prior treatment.
Rituximab – anti-CD20; commonly used off-label.
Corticosteroids plus/minus IVIG – short-term rescue when a rapid platelet rise is needed; avoid prolonged steroid exposure.
Splenectomy – an option for selected patients seeking durable response.
Individualize by bleeding, comorbidities, prior response, treatment burden and patient preference.
Aim for a safe platelet count-not normalization.
Approval and availability vary by country.
Sources: ASH ITP guidelines | FDA rilzabrutinib label.”
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