RT Journal Article
T1 A decade of changes in management of immune thrombocytopenia, with special focus on elderly patients.
A1 Lozano, Maria L
A1 Mingot-Castellano, Maria E
A1 Perera, María M
A1 Jarque, Isidro
A1 Campos-Alvarez, Rosa M
A1 González-López, Tomás J
A1 Carreño-Tarragona, Gonzalo
A1 Bermejo, Nuria
A1 Lopez-Fernandez, Maria F
A1 de Andrés, Aurora
A1 Valcarcel, David
A1 Casado-Montero, Luis F
A1 Alvarez-Roman, Maria T
A1 Orts, María I
A1 Novelli, Silvana
A1 González-Porras, Jose R
A1 Bolaños, Estefanía
A1 López-Ansoar, Elsa
A1 Orna-Montero, Elisa
A1 Vicente, Vicente
K1 Elderly
K1 Guidelines
K1 ITP
K1 TPO-RA
AB Ten years after their availability, thrombopoietin receptor agonists (TPO-RA) have heralded a paradigm shift in the treatment of immune thrombocytopenia (ITP). This study was aimed to analyze the implementation of current recommendations in the standard practice of adult ITP patients, and how age may influence those changes. We included 121 adult patients (> 65 years, n = 54; younger individuals, n = 67) who initiated treatment with TPO-RA between January 2012 and December 2014. Patients older than 65 years treated with TPO-RA presented at diagnosis with significantly higher platelet counts, less bleeding, and a more prothrombotic profile than younger ones. The high efficacy rates of TPO-RA, preferentially used during the last decade in non-chronic phases, precluded from further therapies in the majority of ITP patients. Their administration was associated with a sharp decline in the last decade in the use of splenectomy and intravenous immunoglobulin, especially in younger ITP individuals. These results confirm (1) that there is a preferential use of TPO-RAs in elderly ITP patients with fewer bleeding complications but more unfavorable prothrombotic conditions than in younger individuals, and (2) that early use of these agents has been established as an effective therapeutic alternative to other second line therapies.
YR 2020
FD 2020-09-20
LK http://hdl.handle.net/10668/16322
UL http://hdl.handle.net/10668/16322
LA en
DS RISalud
RD Jul 6, 2025