Understanding your ITP treatment options
Treatments for immune thrombocytopenia (ITP), also known as autoimmune thrombocytopenia, can help reduce the risk of dangerous bleeding.
People with ITP have too few blood-clotting cells (platelets) in their blood. It happens when the body's germ-fighting immune system starts attacking the platelets.
A number of treatments that interfere with that process are available. Here's a look at the options.
Treatment might not be needed right away
Treatment is generally reserved for people with a higher risk of bleeding. If your platelet count isn't very low, you might not need treatment.
This strategy allows you to avoid the side effects of treatments. Your doctor will carefully monitor the number of platelets in your blood so that treatment can begin if your count drops.
Delaying treatment is helpful for:
- Children. In young children, ITP usually goes away within a few months, and it doesn't come back. Most children with ITP don't need treatment.
- Adults. In adults, treatment usually isn't recommended until the platelet count drops very low. It might also be recommended if you develop ITP signs and symptoms, such as easy bruising and easy bleeding.
Medications to stop the body from attacking platelets
Medications can help control or suppress the body's immune system to stop it from attacking the platelets. Options include:
- Steroid drugs. Corticosteroids are usually the first treatment for ITP. They're typically taken in pill form.
- Immune globulin. Immune globulin contains immune system cells collected from blood donors. It is administered through a vein in your arm and is repeated over a few days.
- Other drugs. Other medications that can help control the immune system include rituximab (Rituxan, Truxima) and fostamatinib (Tavalisse).
If initial treatments haven't helped, your doctor might recommend an operation to remove your spleen (splenectomy). The spleen is an organ that sits under your rib cage on the upper left side of your abdomen. It's responsible for removing old and damaged blood cells from the blood. Removing the spleen slows down the destruction of platelets that happens with ITP.
Medications to increase platelet production
Drugs called thrombopoietin receptor agonists stimulate your bone marrow to make more platelet cells. The bone marrow is the spongy material inside your bones where blood cells are made. These medications, including romiplostim (Nplate) and eltrombopag (Promacta), might be options if other treatments haven't helped.
May 22, 2020
See more In-depth
- Hoffman R, et al. Diseases of platelet number: Immune thrombocytopenia, neonatal alloimmune thrombocytopenia and posttransfusion purpura. In: Hematology: Basic Principles and Practice. 7th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed April 25, 2019.
- AskMayoExpert. Immune thrombocytopenia (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019.
- George JN, et al. Immune thrombocytopenia (ITP) in adults: Second and subsequent therapies. https://www.uptodate.com/contents/search. Accessed April 30, 2019.
- Ballow M, et al. Overview of intravenous immune globulin (IVIG) therapy. https://www.uptodate.com/contents/search. Accessed April 30, 2019.