Repeated successful use of eltrombopag in chronic primary immune thrombocytopenia: description of an intriguing case

Primary immune thrombocytopenia (pITP) is an autoimmune disorder characterized either by an increased peripheral platelets clearance or by a decreased platelets production. The goal of pITP therapy is to reach and maintain a safe platelet level to avoid bleedings. International guidelines recommend corticosteroids and/or high‐dose immunoglobulin as first‐line treatment, while splenectomy as a second‐line therapy. In case of contraindication or refractoriness to splenectomy, rituximab or other immunosuppressants and the new thrombopoietin receptor agonists (TPO‐RAs), romiplostim and eltrombopag, are considered alternative treatments 1, 2. In Europe, TPO‐RAs have been approved by EMA for the treatment of chronic pITP patients unresponsive to other therapies.