'On-demand' romiplostim therapy in immune thrombocytopenia

Abstract

What is known and objective Although thrombopoietin receptor agonists are a second-line treatment for refractory immune thrombocytopenia (ITP), we lack guidelines recommending maintenance modality in patients who achieve complete remission (CR). Case summary We report a patient with refractory ITP who achieved CR on romiplostim. Obtaining romiplostim for 6 months of therapy, we decided to try extending this by modifying the standard treatment regimen. Romiplostim was successfully administered 'on-demand', only if the patient's platelet count dropped below 150 × 109/L, over a period of 12 months. What is new and conclusion The strategy of 'on-demand' therapy is a promising procedure for the maintenance of response, lowering costs and improving treatment safety. © 2016 John Wiley & Sons Ltd.