Mitrovic, M. (54972086700)M. (54972086700)MitrovicElezovic, I. (12782840600)I. (12782840600)ElezovicSuvajdzic-Vukovic, N. (7003417452)N. (7003417452)Suvajdzic-Vukovic2025-07-022025-07-022016https://doi.org/10.1111/jcpt.12359https://www.scopus.com/inward/record.uri?eid=2-s2.0-84970939244&doi=10.1111%2fjcpt.12359&partnerID=40&md5=6813ad0d5b5413464ac71d5ecfcb0c02https://remedy.med.bg.ac.rs/handle/123456789/13417What 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.'on-demand' therapyimmune thrombocytopeniathrombopoietin receptor agonists