“Your doctor may have few patients with ITP, and the most current information is helpful,” she says.
Treating chronic ITP can be difficult, Dr. Gernsheimer festival. Medications do not always work for everyone and can cause side effects. Some treatments can be expensive or require weekly medical appointments. You may also find that treatment becomes less effective over time and you feel like you are back on the drawing board. You need to work closely with your doctor to treat chronic ITP over the long term.
After all, you need to consider some treatments. Here are some of the options for chronic ITP treatment.
While you are finding out long-term treatment for your chronic ITP, your doctor may start you on corticosteroids to bring your platelets to a safer threshold in the short term, according to the Mayo Clinic.
“These drugs suppress the immune system and reduce the destruction of blood platelets,”
Corticosteroids can be an extremely effective treatment, says Dr. Gernsheimer. With longer use, steroids can also have side effects such as increased blood pressure, high blood sugar, insomnia and an increased risk of infection, according to the Mayo Clinic. For this reason, doctors will prescribe them primarily on a short-term basis to quickly increase your platelet levels and find another long-term solution to your chronic ITP.
2. Thrombopoietin receptor agonists
Thrombopoietin receptor agonists are a relatively new treatment for chronic ITP, but have already been shown to be quite effective. They stimulate the bone marrow to produce platelets, says Dr. Gernsheimer, and thus contribute to increasing your blood platelet count. There are several thrombopoietin receptor agonists, and depending on which one you use, you can take the medicine as a daily pill or weekly.
While some people can break down thrombopoietin receptor agonists and maintain their platelet count, most people with chronic ITP who use this type of drug have to continue their pills or injections indefinitely, says Dr. Novel.
3. Intravenous immunoglobulin
If your platelets drop to a critically low level and your doctor wants to change things quickly, he may treat you with intravenous immunoglobulin (IVIg), says Dr. Gernsheimer. The active ingredient in this drug, according to the American College of Rheumatology, are immunoglobulins or antibodies derived from donor plasma.
People with chronic ITP can see higher platelet counts 24 hours after receiving IVIg and usually stay high for about a month, says Dr. Gernsheimer. However, treatment takes a while – usually at least three hours – and can cost around $ 10,000 per session (which may not be covered by insurance). For this reason, IVIg is normally reserved for emergency situations.
Unlike some other treatment options on this list, IVIg does not increase the risk of infection, according to the American College of Rheumatology. However, it can cause side effects like fever, chills, headache, and more.
Infusions of a drug called rituximab can also be used to treat chronic ITP. This drug is a type of monoclonal antibody that, according to the National Cancer Institute, is a laboratory-engineered protein that can bind to certain cells. According to the Mayo Clinic, rituximab helps suppress the immune response that destroys your platelets, which can ultimately increase your platelet count.
Rituximab can be used well as a chronic ITP treatment, says Dr. Gernsheimer, however, has some disadvantages. Treatment includes injections once a week for a month – and your first infusion can last four to six hours, with subsequent infusions lasting about three to four hours. And while it helps stop your platelets from being destroyed, rituximab can make your vaccines less effective, according to the Mayo Clinic. Overall, this can be a problem, but is particularly worrying if your chronic ITP treatment removes the spleen, increasing the risk of infection.
5. Other immunosuppressants
A number of immunosuppressants can also be effective against chronic ITP, says Dr. Gernsheimer. These drugs work by reducing the activity of the entire immune system, which can increase platelet counts in people with ITP.