Later-Line Management of ITP

CE / CME

Fundamentals II: Optimizing Later-Line Treatment of ITP and Improving Awareness of Emerging Options

Physician Assistants/Physician Associates: 0.75 AAPA Category 1 CME credit

Nurse Practitioners: 0.75 Nursing contact hours, includes 0.75 hour of pharmacotherapy credit

Released: October 18, 2024

Expiration: April 17, 2025

Tara Azizi
Tara Azizi, MSN, AGPCNP-BC, CRNP
Lucus W. Enslin
Lucus W. Enslin, MSN, FNP-BC
Jennifer Mead
Jennifer Mead, PA-C

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Patient Case: 71-Yr-Old Woman



  • 71-yr-old woman with a history of hypertension, hepatitis B virus infection, and poorly controlled diabetes mellitus was diagnosed with ITP 1 mo ago

  • She is of Southeast Asian ancestry

  • She had a short-lived response to IVIG and is unable to be tapered off prednisone without her platelet count dropping <10,000/µL

  • She is complaining of increased gingival bleeding

  • You discuss various second-line treatment options with her

    • In your discussions, you compare the mechanism of action of the different treatment options, efficacy, and safety data 

    • You also discuss the differences among the TPO-RAs vs rituximab vs splenectomy



  • During the discussion, she shares with you that her son cannot take time off work to drive her to the clinic weekly; so, she prefers an orally available option

What is the next best treatment option for this patient?