About ITP
Treatment Goals
ITP Treatments
Talking to Your Doctor
About Treatments

About ITP

What is ITP?

Immune thrombocytopenia [throm-boh-sahy-tuh-pee-nee-uh], also called ITP, is a condition in which your blood does not have enough platelets. Platelets are components found in blood that help form clots to stop bleeding and bruising.

How can ITP affect me?

There are several ways ITP can affect you, causing your platelets to drop to very low levels and leading to symptoms of ITP. This happens because:

Healthy platelets are destroyed. The immune system mistakenly attacks and destroys healthy platelets, which grow in the bone marrow.

The body doesn’t create enough platelets to make up for the platelet destruction. The body doesn’t make enough platelets.





Finding the treatment that works for you may help you keep your ITP under control and continue to enjoy the daily activities you love doing.


Types of ITP

There are 3 types of ITP: Acute, persistent, and chronic



Timeline of types of ITP: acute (0-3 months), persistent (3-12 months), and
chronic (12 months or longer)


Acute ITP, also known as short-term or temporary ITP, usually lasts less than 3 months. It mainly occurs in children and often goes away on its own within a few weeks or months.

If it has been between 3 and 12 months since your diagnosis, your condition is considered persistent.

Chronic ITP, also known as long-term ITP, lasts 12 months or longer and mostly affects adults. It can last for many years and may require continued treatment.

7 out of 10 icon Seven of 10 children with acute ITP will see it go away within 12 months, with or without treatment. For a small number of children, ITP becomes chronic.

5 out of 10 icon Approximately 5 of 10 adults with ITP have persistent or chronic ITP despite treatment.


Even though an ITP diagnosis can be overwhelming, it's important to keep in mind that:


Sunset people
Patient portrayal.
Managed with treatment

It can be managed with treatment.

Talking to your doctor

Talking with your doctor can help determine which option may be right for you.

You’re not alone.

You’re not alone. There are online communities with patients just like you where you can go for answers to questions as well as support.


Treatment
Goals

What are your treatment goals?

A group of medical experts from around the world published the International Consensus Report (ICR), which provides up-to-date information about how to best manage ITP.

The ICR also provides recommendations for the goals of treatment, which are focused on improving both your daily life and condition. Beyond controlling your platelet count, your personal goals are something you should discuss with your doctor based on what matters to you—whether it’s improving your fatigue, managing side effects, or being able to travel or pursue your passions.

As you learn about your treatment options and have discussions with your doctor, it may be helpful for you to keep these goals from the ICR in mind.

ICR-recommended treatment goals


Your treatment goals should be specific to you and the phase of your ITP.
Personalized goals
Your treatment goals should be specific to you and the phase of your ITP.
Your treatment should help you feel better physically and emotionally.
Help improve your daily life
Your treatment should help you feel better physically and emotionally.
You and your doctor should discuss side effects that may get in the way of your daily life.
Understand side effects
You and your doctor should discuss side effects that may get in the way of your daily life.
Treatment should help you reach a target platelet count of at least 20,000 to
30,000 platelets per microliter.
Platelet counts
Treatment should help you reach a target platelet count of at least 20,000 to 30,000 platelets per microliter.
Treatment should prevent severe bleeding.
Help prevent bleeding
Treatment should prevent severe bleeding.

Talk to your doctor if your current treatment does not help you meet your goals. Other treatment options may be available.


ITP
Treatments

Are there guidelines for how to treat ITP?

The American Society of Hematology (ASH) is another major group of experts that doctors around the world look to for guidance about treating ITP. ASH created a set of ITP treatment guidelines based on the latest evidence. Your doctor may consult these before discussing your treatment options with you.

Keep reading to get the facts about treatment and guidelines so you can work with your doctor to find the right option for you.


Getting started on treatment

Corticosteroids

Corticosteroids image Corticosteroids [kor-tuh-koh-steh-roydz] (commonly referred to as “steroids”) are usually the first treatment people receive for periods of 6 weeks or less after being diagnosed with ITP.

Corticosteroids may help increase the number of platelets in your blood (also referred to as “platelet count”). However, generally, platelet levels only stay high without treatment (remission) for less than 2 of 10 people who take them.

As many as 8 of 10 people may not experience remission with corticosteroids. You should also know that corticosteroids are known to cause many side effects, including weight gain, sleep and mood issues, stomach irritation, high blood sugar, effects on mental health, high blood pressure, ulcers, glaucoma, and muscle and bone diseases.

For these reasons, ASH recently changed its treatment guidelines to recommend people only be treated with corticosteroids for periods of 6 weeks or less.

Intravenous immunoglobulin [in-truh-vee-nuhs i-myoo-no-glaa-byuh-luhn], or IVIg, is a treatment option that may be used to quickly raise platelet counts in people with newly diagnosed ITP.

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.



Changing treatments

Changing treatments image
Patient portrayal.

There are several reasons why you and your doctor may discuss changing your treatment:

  • Corticosteroids do not work for you
  • Corticosteroids worked for you, but your
    platelet counts dropped once treatment
    stopped. In this case, your doctor may try
    another course of steroids or consider a different
    kind of treatment
  • Treatment or its side effects interfere with your daily life
  • Your symptoms are not addressed by your current treatment

There are several types of available treatments you and your doctor may consider next.


TPO-RAs

Corticosteroids image Patient portrayal. If you stop taking corticosteroids for any of the reasons mentioned above but prefer a medication that offers long-lasting control of your platelet counts, the ASH treatment guidelines suggest a type of medication called a TPO-RA (short for thrombopoietin [throm-bo-poy-eh-tin] receptor agonist).

TPO-RAs are proven to boost the number of platelets in your body and keep them high for long periods of time—in some cases, several years. TPO-RAs can also help reduce bleeding.

ASH guidelines suggest 2 options: An oral pill you take once every day or an injection you get once a week at your doctor’s office. The option you and your doctor choose depends on how you prefer to take your medication.



Monoclonal Antibodies

Patient portrayal.

Another option you and your doctor may consider after corticosteroids is a treatment known as a monoclonal antibody, which is given by infusion. An infusion is having your medicine administered through a needle placed directly into a vein and must be done at a treatment center or hospital.

Monoclonal antibodies work by suppressing how your immune system works—similar to corticosteroids. This can help increase your platelet counts. You would take several infusions before you stop taking treatment and wait to see if it worked for you.

ASH encourages physicians to incorporate shared decision making into treatment choices. You and your doctor should decide whether to take a TPO-RA or monoclonal antibody based on your preferences and treatment goals.


Splenectomy

Corticosteroids image

You and your doctor may discuss removing your spleen in a surgery called a splenectomy [spluh-nek-tuh-mee].

Your spleen helps your immune system fight infections. When you have ITP, your immune system fights platelets by mistake. By removing the spleen, your body may destroy fewer platelets. However, there is no test to show whether or not a splenectomy would work for you. Once the spleen is removed, the procedure cannot be reversed. As with any surgical procedure, you should consider the risks carefully and discuss your concerns with your doctor.

ASH treatment guidelines recommend waiting at least 1 full year after you are diagnosed before considering surgery for spleen removal.




Learn more about your treatment options with an interactive treatment discussion tool.




Working together with your doctor

When you've been recently diagnosed with ITP and are still in the acute phase of your condition, you may find that taking several short rounds of corticosteroids can be exhausting and even interfere with your daily life. For patients who move to the chronic stage of ITP, it is important to remember that you may require longer-term treatment. This means that you should consider how your treatment options will impact your daily life, address your symptoms, and help control your ITP.

While the ASH guidelines provide doctors with guidance for treating ITP, they also highlight that you and your doctor should discuss all of your options and work together to decide which treatment is right for your personal goals. It is important to be vocal about what matters to you.


Talking to your doctor
Talk to your doctor
about your
personal goals
Patient portrayal.
Balancing quality of life
Personalizing
your goals
Controlling
platelet counts
Preventing
bleeding
Managing side
effects
Have a discussion with your doctor to determine which treatment is right for you!

Talking to
your doctor
about
treatments

Use the interactive treatment tool below to help start a conversation with your doctor about your preferences when it comes to ITP treatments.

Instructions
  1. Review the information regarding different ITP treatment options.
  2. After reviewing the chart, determine which treatment options you are interested in learning more about to receive suggested conversation starters that may be helpful for your discussion with your doctor.
  3. Print your conversation starters and bring them to your next appointment to discuss your treatment preference or complete this exercise together with your doctor at your next visit. It is important to work with your doctor to find a treatment that helps you achieve what is important to you.

Start here
I am interested in having a conversation to learn more about how these treatments would work for me: (select yes or no)


NEXT: Learn about the ITP journey