It is usual to treat idiopathic thrombocytopenic purpura with a corticosteroid, e.g. prednisolone 1mg/kg daily, gradually reducing the dose over several weeks. For other treatments such as IV immunoglogulin and immunosuppressants discuss with a Consultant Haematologist.

Avatrombopag

• Tablets 20mg

Notes

1. NICE TA626: Avatrombopag (Doptelet) is recommended, within its marketing authorisation, as an option for treating severe thrombocytopenia (that is, a platelet count of below 50,000 platelets per microlitre of blood) in adults with chronic liver disease having a planned invasive procedure (June 2020).
2. NICE TA853: Avatrombopag (Doptelet) is recommended, within its marketing authorisation, as an option for treating primary chronic immune thrombocytopenia (ITP) refractory to other treatments (for example, corticosteroids, immunoglobulins) in adults, only if the company provides it according to the commercial arrangement (December 2022).

Eltrombopag

• Tablets 25mg, 50mg, 75mg
• Powder for oral solution in sachets 25mg

Notes

1. Consultant haematologist only
2. NICE TA293: Eltrombopag (Revolade) is recommended as an option for treating chronic immune (idiopathic) thrombocytopenic purpura in adults, only if the criteria specified in NICE TA293 are met (October 2018)
3. MHRA Drug Safety Update (July 2018): Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results. Refer to update for further details.

Fostamatinib

• Tablets 100mg, 150mg

Notes

1. NICE TA835: Fostamatinib (Tavlesse) is recommended as an option for treating refractory chronic immune thrombocytopenia (ITP) in adults (October 2022), only if:
   1. they have previously had a thrombopoietin receptor agonist (TPO-RA), or a TPO-RA is unsuitable and
   2. the company provides it according to the commercial agreement

Lusutrombopag

• Tablets 3mg

Notes

1. NICE TA617: Lusutrombopag (Mulpleo) is recommended as an option for treating severe thrombocytopenia in adults with chronic liver disease having planned invasive procedures (January 2020)

Romiplostim

• Powder for solution for injection vials 125microgram
• Powder and solvent for solution for injection vials 250microgram

Notes

1. Consultant haematologist only
2. NICE TA221: Romiplostim (Nplate) is recommended as an option for treating chronic immune (idiopathic) thrombocytopenic purpura in adults, only if the criteria specified in NICE TA221 are met (October 2018)

Essential thrombocythaemia

Anagrelide

• Capsules 500 micrograms

Notes

1. Consultant haematologist only