Doptelet for the treatment of primary chronic immune thrombocytopenia (ITP) in adult patients

What is primary chronic ITP?

ITP is an autoimmune disease that affects 3.3 per 100,000 individuals annually. It is characterised by low platelet counts (<100,000/µL or 100 x 10⁹/L) and increased bleeding risk.^1,2 The pathophysiology of primary adult ITP can be quite complex and is not fully understood. In general, primary ITP manifests as thrombocytopenia caused by platelet destruction and suppressed platelet production.³

There are 2 types of immune thrombocytopenia, based on the cause of the condition. Most adults who are diagnosed with ITP will have primary ITP. It is considered an acquired immune disorder, meaning it was not inherited genetically or caused by another illness. Secondary ITP is more commonly found in children after an inciting event such as a viral or bacterial infection. It is associated with better outcomes as it is possible to treat or eliminate the infection. Primary ITP makes up approximately 80% of adult ITP diagnoses.^2,3

The impact of ITP

Petechiae, bruising, epistaxis and gum bleeding are common symptoms associated with ITP.⁴ Though severe bleeding events such as intracranial haemorrhage or gastrointestinal bleeding are relatively uncommon, they are the primary concern that drives treatment of ITP.⁴ The condition can greatly impact patients’ quality of life in a variety of ways other than bleeding, with fatigue and anxiety around maintaining a stable platelet count being reported as frequent and severe.⁵

Treating primary chronic ITP

Corticosteroids are the standard first-line treatment for newly diagnosed patients with ITP, though guidelines recommend they are used for a limited amount of time.^6–8 The main goal of subsequent treatment is to attain a sustained increase in the platelet count that is considered haemostatic for the individual patient, while minimising AEs, and allowing for the possibility of attaining remission.⁸ International guidelines recommend using TPO-RAs as second-line therapy in adult patients with chronic ITP.^6–8

How can Doptelet help patients
with primary chronic ITP?

Doptelet is an orally administered TPO-RA that mimics the biologic effects of TPO in stimulating the development and maturation of megakaryocytes, leading to an increased platelet count.⁹ It is approved for the treatment of primary chronic immune thrombocytopenia in adult patients who are refractory to other treatments such as corticosteroids or immunoglobulins.⁹ TPO-RAs, including Doptelet, are recommended by ICR guidelines as a preferred subsequent therapy for adult patients with chronic ITP.^*8