Comparative Retrospective Study of Therapies and Trends for Hospitalized Patients with New-Onset Immune Thrombocytopenia

BackgroundImmune Thrombocytopenia is an autoimmune condition characterized by isolated thrombocytopenia and exclusion criteria. The U.S.'s incidence of ITP is 6.1 and greater in females, with bimodal distribution for ages 0-4 and 65+ years.¹ ITP ranges in severity, with high economic cost (estimated U.S. expenditures of over $400 million).¹ Despite ITP clinical updates, little research focused on hospitalized patients during first onset of ITP exists.AimsWe hope this study advances clinical practice for hospitalized patients with new-onset ITP.MethodsWe conducted retrospective chart review of adult patients with ITP treated at University Hospital or Mays Cancer Center between January 2020-January 2023, focusing on patients initially diagnosed inpatient. Data were reviewed in descriptive analysis.Results25 of 35 patients with inpatient onset/diagnosis of ITP were included. 20 had primary etiologies; 5 had secondary etiologies. Our group was largely Caucasian (13) and Hispanic (11).The majority were women (16) compared to men (9). One was pregnant; none had HIV. For these patients with first-onset of ITP while hospitalized, 6 received steroids, 1 received IVIG, 11 received both steroids and IVIG, and 7 had additional regimens (including observation, rituximab, splenectomy, plasmapheresis) during hospitalization. Platelet nadir and trends post-treatment days 1-3 were almost identical between the steroids-alone and steroids + IVIG group (Figure 1). Length of hospital stay after therapy onset was shortest for steroids + IVIG (4.9 days), followed by the steroids-alone (5.8 days), IVIG-alone (7 days), and other regimens (11.6 days) groups.Conclusion(s)In hospitalized patients with first-onset ITP, the first-line regimens of steroids-alone and steroids with IVIG had the best clinical results. Steroids-alone and steroids + IVIG yielded almost identical platelet responses, yet slightly longer hospitalization for steroids-alone group. We hope this study better informs our clinical practice of initial treatment of ITP inpatient. Further research increasing samples/population will amplify study power and generalizability.

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