Premium
Combination therapy in relapsed or refractory chronic immune thrombocytopenia: a case report and literature review
Author(s) -
Rashidi A.,
Blinder M. A.
Publication year - 2016
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12421
Subject(s) - immune thrombocytopenia , refractory (planetary science) , medicine , intensive care medicine , platelet , physics , astrobiology
Summary What is known and objective Immune destruction and decreased platelet production are major components of immune thrombocytopenia ( ITP ) pathogenesis. The aim of this study was to critically evaluate the role of combination therapy in relapsed/refractory ITP and the concept of medication tapering/discontinuation. Comment Although a number of combination regimens have been reported, little is published on combining immunosuppression with thrombopoietin receptor agonists ( TPO ‐ RA s). We report a case of refractory ITP successfully treated with combination immunosuppression added to eltrombopag. An aggressive combination approach resulted in complete remission and allowed for stepwise drug tapering. What is new and conclusion Combination immunosuppression can potentiate the effect of TPO ‐ RA s. This mechanistically reasonable strategy could result in a more rapid response than the more popular, sequential, single‐agent strategy. Stepwise tapering can be successfully implemented. Comparing sequential single‐agent therapy with early combination approach warrants a more extensive study.