Abstract: BACKGROUND: Low platelet counts resulting from increased platelet breakdown and poor platelet generation are the hallmarks of immune thrombocytopenia (ITP), an autoimmune illness. Romiplostim increases platelet counts in the majority of patients and lowers bleeding risk in those with ITP. OBJECTIVES: To evaluate the median dose of romiplostim required to maintain platelet counts ≥50 × 10 9 /L and to assess platelet response rates among adult Iraqi patients with primary ITP. MATERIALS AND METHODS: The cross-sectional study looked at 200 patients’ ages ≥14 years who had primary ITP that failed 1 st line treatment. They were treated at Baghdad Medical City from May 2022 to December 2023. Medical records were used to get the information. Romiplostim (Nplate ® , Amgen Inc., Thousand Oaks, CA, USA) was injected subcutaneously once a week. The dose started at 1 μg/kg and was increased by 1 μg/kg each time to keep the platelet numbers between 50 and 200 × 10 9 /L (maximum 10 μg/kg). RESULTS: Among 200 patients (60% female), the median age was 38 years and the median treatment duration was 4 months. The median weekly dosage of romiplostim was 250 μg and the median baseline platelet count was 19 × 10 9 /L, which significantly increased to 138 × 10 9 /L after romiplostim therapy ( P = 0.011). A total of 73.5% of patients achieved a platelet response ≥ 50 × 10 9 /L. There was no significant difference in response between patients aged ≥ 60 years and those < 60 years ( P = 0.25). CONCLUSIONS: Romiplostim has a robust and persistent platelet response in adult patients with refractory ITP and good safety. Its effectiveness as a second-line treatment was confirmed by its age-neutral response.
Naji et al. (Sat,) studied this question.
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