A decade of changes in management of immune thrombocytopenia, with special focus on elderly patients

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 implementation current recommendations standard practice adult ITP patients, and how age may influence those changes. We included 121 patients (> 65 years, n = 54; younger individuals, 67) who initiated with TPO-RA between January 2012 December 2014. Patients older than treated presented at diagnosis significantly higher platelet counts, less bleeding, more prothrombotic profile ones. The high efficacy rates TPO-RA, preferentially used during last decade non-chronic phases, precluded from further therapies majority patients. Their administration associated sharp decline use splenectomy intravenous immunoglobulin, especially individuals. These results confirm (1) that there is preferential TPO-RAs elderly fewer bleeding complications but unfavorable conditions (2) early these agents has been established as an effective therapeutic alternative other second line therapies.