PDSA Media Relations

Press Kit - Treatments for ITP

Back to Media Page

Q: What treatments are available?

A: There are many treatments for ITP. They all have different risks and benefits and some are very toxic. It is important to understand both the success rate and potential side effects before beginning a treatment. Hematologists may use several treatments at once to increase their success rate.

Treatments include (in alphabetical order) anti-D (WinRho SDF®), azathioprine (Imuran®), corticosteroids (ex. prednisone), cyclophosphamide (Cytoxan®), cyclosporine (Sandimmune®), danazol (Danocrine®), gamma globulin (ex. IVIg), mycophenolate mofetil (Cellcept®), rituximab (Rituxan®), splenectomy, and vinca alkaloids (ex.vincristine). Additional treatments are in clinical trials. Some patients report success with complementary therapies such as vitamins, supplements, diet changes, herbs and energy work.

Q: Are there treatment guidelines?

A: ITP treatments vary with the severity of the disease, age of the patient, the experience of the hematologist and other factors. Both the American Society for Hematology and the British Society for Haematology have published guidelines for treating ITP. However, there is no consensus on a treatment protocol. ITP treatment is evolving as researchers learn more about the disease.

Q: Is there one treatment that is usually recommended?

A: An initial course of prednisone is often given to newly diagnosed patients. Prednisone suppresses the immune system. It is hoped that suppressing the immune system will cause the patient’s platelet count to increase and remain elevated after the patient stops taking prednisone.
Sometimes a short course of dexamethasone, another corticosteroid, is used instead of prednisone.

Q: What are the side effects of these treatments?

A: Side effects have been reported for each of the drugs used to treat ITP. However, side effects will vary from one person to another. Patients may experience all, some, or no side effects at all. Side effects for frequently used treatments are described below.

Prednisone — Prednisone is a synthetic medicine (i.e., steroid) similar to cortisone, a natural substance produced in the body’s adrenal glands.

Possible side effects: Prednisone is generally only given for a few weeks at a time because it can have serious side effects with long-term use. And even when it is given for a short time, patients may become more irritable, have stomach upsets, sleep disturbances, increased appetite, weight gain, puffy cheeks, frequent urination, sugar in the urine, loss of bone density, or acne. When the medicine is stopped, most side effects will begin to disappear.

Intravenous gamma globulin (IVIg) — IVIg is a liquid concentrate of antibodies purified from the plasma (the liquid portion of the blood that doesn’t contain red blood cells) of healthy blood donors. IVIg is believed to work by overwhelming the spleen with antibody so that it cannot recognize the antibody-coated platelets. IVIg treatment will usually result in a rapid (24 to 48 hours) increase in the platelet count, but any improvement is generally short-lived. Treatment may be repeated until the platelet count improves. IVIg is deliverd by an intravenous infusion directly into a vein in the arm for several hours a day over a period of 1 to 5 days.

Possible side effects: Some patients treated with IVIg experience nausea and vomiting, headaches or fever and rarely, aseptic meningitis, abnormal blood clots or kidney failure.

Anti-Rho(D) immune globulin (WinRho®) — WinRho is also a liquid concentrate of antibodies derived from healthy human plasma. However, this medicine is targeted against the Rh factor* on red blood cells. It is thought that WinRho binds to red blood cells to such an extent that the spleen is fully occupied eliminating red blood cells and does not have much opportunity to remove the antibody-coated platelets. Like IVIg, the response is usually rapid but temporary. If a hematologist recommends treating with WinRho, it will be given by intravenous infusion. The procedure
takes less than a half hour and can be done during an outpatient visit. WinRho will generally not work if a patent is Rh-negative or has had a splenectomy (removal of the spleen).

Possible side effects: Temporary side effects from WinRho include fever, headache, chills, nausea and vomiting, anemia, and rarely, kidney failure. Other treatments —You can contact our organization or visit our Web site (www.pdsa.org) for information about these.

Q: Do alternative treatments work?

A: Some people report success with herbs, supplements, energy work, diet changes and other alternative treatments. There are many reported cases of their success but few formal studies. Many of the alternative treatments attempt to correct the underlying problem rather than treat the symptoms of the disease. They tend to take a longer time to be effective and have fewer unwanted side effects. Like the more traditional treatments, the alternative treatments do not have the same results in all who try them.

Back to Media Page