Persistent or Chronic ITP Clinical Trial
Official title:
Rate of Prolonged Response After Stopping Thrombopoietin-receptor Agonists Treatment in Immune Thrombocytopenia: a Prospective Multicenter Open Study
Thrombopoietin-receptor agonists (Tpo-RAs) have profoundly changed the management of ITP.
However, today, there are no international recommendations concerning the long-term use of
these costly, potentially pro-thrombotic agents, and that could induce bone marrow fibrosis
in case of prolonged treatment. Tpo-RAs have been thought to play only a supporting role in
ITP management. But our center along with many other research centers, have reported
unexpected cases of durable remission after Tpo-RAs discontinuation in adult chronic ITP. In
these retrospective studies, more than 20 % of patients were able to achieve prolonged
remission.
The purpose of this study is to demonstrate that a substantial proportion of ITP patients may
achieve a prolonged response after Tpo-RA discontinuation.
The investigators developed, in this study, a standardized procedure to discontinue
Eltrombopag and Romiplostim, wherein the dose will be slowly tapered to limit the risk of
bleeding. In case of relapse after Tpo-RA discontinuation, the decision to start a new
therapy will be based on the clinician's judgment.
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