Abstract
Clinical research has resulted in an improvement of treatment options for patients with immune thrombocytopenia (ITP) over the last years. However, only few data exist on the real-life management of patients with ITP. To expand the knowledge, a multicenter, national survey was undertaken in 26 hematology practices distributed all over Germany. All patients with a diagnosis of ITP were documented using questionnaires, irrespective of the diagnosis date over a period of 2 years. Overall, data of 1023 patients were evaluated with 56% of patients being older than 60 years. Seventy-nine percent of the patients had chronic (> 12 months), 16% persistent (> 3–12 months), and 5% newly diagnosed (0–3 months) ITP. In 61% of cases, the disease lasted 3 or more years before survey documentation started. Main strategies applied as first-line therapy consisted of steroids in 45% and a “watch and wait” approach in 41% of patients. During second- and third-line strategies, treatment with steroids decreased (36% and 28%, respectively), while treatment modalities such as TPO-RAs increased (19% and 26%, respectively). As expected, patients with a low platelet count and thus a higher risk for bleeding and mortality received treatment (esp. steroids) more frequently during first line than those with a higher platelet count. Up to a third of patients were treated with steroids for more than a year. Overall, our study provides a cross-section overview about the current therapeutic treatment landscape in German ITP patients. The results will help to improve therapeutic management of ITP patients.
Highlights
Immune thrombocytopenia (ITP) is an autoimmune disorder, characterized by transient or persistent decrease of the platelet count [1,2,3]
The 26 participating hematology practices provided all available data of their ITP patients by means of a questionnaire designed for the retrospective data collection
The data of 1023 patients treated in 26 hematology practices distributed all over Germany were evaluated, giving a strong picture of real-world ITP treatment
Summary
Immune thrombocytopenia (ITP) is an autoimmune disorder, characterized by transient or persistent decrease of the platelet count (less than 100 × 109/l) [1,2,3]. Patients with ITP have no clinical symptoms and the diagnosis is due to a routine blood analysis. ITP is diagnosed because of mild bleeding symptoms, with severe bleeding being a relatively rare event [5]. The diagnosis of ITP is established only after exclusion of secondary causes of thrombocytopenia, like infections, autoimmune or myeloid disorders, as there are no diagnostic tests to confirm ITP [3]. While the 2011 guidelines of the American Society of Hematology (ASH) suggest treatment for newly diagnosed adult patients with a platelet count < 30 × 109/l irrespective of
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