Real world experiences in the treatment of immune thrombocytopenia over a two-year period

Introduction: ITP is an autoimmune disorder mostly treated in the outpatient setting. This study was conducted to analyze the real-world outcomes of outpatient care for ITP patients on treatment. Methods: Data from patients who had a diagnosis of primary ITP and on or requiring treatment between 01/2020 to 12/2021 in the routine outpatient practice were retrospectively analyzed. Results: Of 91 patients identified, at initial diagnosis the mean age was 55 (range 11-90). 81 patients (89%) had a chronic ITP. The mean platelet count at the time of diagnosis was 26 g/l (range 1-89 g/l). The primary indication for treatment was thrombocytopenia (n=80, 88%); mean 26.2 x 109/l (range 1-89 x 109/l). The first line treatment was mainly corticosteroids (56%, n=51). The mean number of therapies and therapy lines was 3.45 (median 2, range 1-15) and 2.88 (median 2, range 1-10) respectively. Across all therapy lines, 82% of patients (n= 75) had corticosteroids, 77% (n=70) thrombopoietin receptor agonists, 48% (n=44) IVIG, 12% (n=11) rituximab, 5% (n=5) fostamatinib and 6% (n=7) splenectomy. 314 therapies were administered during the study duration and patients achieved CR, R, and NR in 39% (123/314), 18% (56/314) and in 43% (135/314) respectively. No grade III bleeding was documented during treatment. Conclusion: We conclude that ITP can be safely managed in the outpatient setting despite the challenges involved in the care of this patient cohort. Close cooperation with regional hospitals allows inpatient care when necessary.