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Agents that stimulate platelet production represent a major advance in the treatment of immune thrombocytopenia purpura (ITP). In many patients, these drugs increase platelet count by inducing sufficient platelet generation to compensate for the heightened platelet destruction. We previously reviewed trials of two such agents, romiplostim (JW Oncol Hematol Feb 12 2008) and eltrombopag (JW Oncol Hematol Dec 18 2007).
Now, an international team of investigators is reporting outcomes of 234 patients with ITP who were randomized to receive either standard care (77 patients) or weekly injections of romiplostim (157 patients) for 1 year. At baseline, all patients had platelet counts <50,000/µL and had not undergone splenectomy. Most patients had p…