Dr Frederick Chen speaks to ecancer about real world evidence from the UK Adult ITP Registry evaluating the thrombopoietin receptor agonist romiplostim in acute immune thrombocytopenia (ITP) treated during the COVID 19 pandemic.

The study examines upfront romiplostim use either as monotherapy or following initial corticosteroids with or without intravenous immunoglobulin in newly diagnosed patients, reflecting a period of broader first line use to preserve immune responses to infection and vaccination.

Dr Chen says that across 34 patients, romiplostim demonstrated rapid and robust efficacy, with median time to platelet response above clinically meaningful thresholds occurring within approximately 7 to 12 days and over 90 percent of patients achieving target platelet counts by 100 days.

Both treatment approaches showed high response rates, with no significant differences in time to response between monotherapy and combination strategies, despite baseline differences in disease severity.
Sustained responses were observed in nearly half of responders, with many patients able to discontinue treatment and maintain platelet stability for extended follow up.

These findings support the effectiveness of romiplostim as an early treatment option in acute ITP and suggest potential for risk adapted first line strategies, although larger studies are needed to confirm optimal treatment stratification.