Perioperative treatment for patients with immune thrombocytopenia: Eltrombopag vs IVIG

What is this research about?

Patients with immune thrombocytopenia (ITP) have low platelet counts and this can put them at risk for bleeding. There are treatments available to increase the platelet count in patients with ITP and this can be crucial in situations associated with blood loss, such as invasive surgeries. Intravenous immunoglobulin (IVIG) is commonly used to increase the platelet count before surgery for ITP patients, although available treatment options also include corticosteroids and eltrombopag, an oral medication that stimulates production of platelets. However, in addition to the many considerations that influence treatment preference, it is unclear if eltrombopag is non-inferior to IVIG as a perioperative treatment.

IVIG is made of concentrated proteins, specifically antibodies, that have been collected from plasma. However, IVIG is an expensive blood product in short supply and it can have side effects such as allergic reactions, headaches, and hemolysis. Corticosteroids may be avoided prior to surgeries as it can affect wound healing. Eltrombopag carries potential risks such as thrombosis and liver toxicity.

This study compared eltrombopag and IVIG for patients with ITP around the time of surgery. This is the only randomized control trial to date that has examined perioperative treatments for patients with ITP.

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