Real-World Retrospective Analysis of Immune Thrombocytopenia Patient Demographics and Treatment

Background

Immune thrombocytopenia (ITP) is a serious immune-mediated phenomenon with an increasing incidence of 6.1 per 100,000 people. This incidence almost doubles in older adults 65 years or older, with an increased mortality risk found in fatal bleeding. Several treatment options are available, including corticosteroids, rituximab, splenectomy, thrombopoietin receptor agonists (TPO-RA), immunosuppressives, and spleen tyrosine kinase inhibitors.

Aims

This retrospective study aims to investigate the ITP demographics and the preferred treatment modalities in a dataset from real-life clinic practice.

Methods

We conducted a retrospective chart review of adult patients diagnosed with ITP and treated in eit her inpatient or outpatient between January 2020 to January 2023. Data variables were collected and reviewed in descriptive analysis.

Results

Our study included 109 patients with ITP diagnosis. The most common ethnicity was White or Caucasian (52 patients, 48%) and Hispanic or Latino (42 patients, 39%). Many patients had primary ITP (82 patients, 75%), while 25% (27 patients) had secondary ITP with the most had concurrent active autoimmune disease (11 patients, 42%). 60% treated outpatient and 40% inpatient. At the time of diagnosis, 27 (25%) patients had bleeding episodes; and major bleeding occurred only in 4 (4%) patients. Initial treatments were steroid monotherapy (43 patients, 39.4%), observation only in 31 (28%) patients, and steroid and IVIG combination in 24 (22%) patients. Subsequently, 55 (50%) patients experienced refractory or relapsed disease, with Rituximab (17 patients, 31%) as the most common second-line treatment. The most common third-line treatment was Romiplostim (7 patients, 23%) and Rituximab (7 patients, 23%), whereas the fourth-line treatment was Eltrombopag (7 patients, 32%).

Conclusion(s)

This retrospective study provides the largest ITP analysis to our knowledge. Further research, including survival analysis, is needed to optimize the sequencing of subsequent ITP treatments and enhance patient outcomes in this challenging disease phenomenon.

Bowhay-Carnes:Rigel: Speakers Bureau; Alnylam: Speakers Bureau.