Abstract

A BRIEF REPORT ON: THE EFFICACY AND SAFETY OF SECOND LINE AGENT ROMIPLOSTIM IN PATIENTS WITH IMMUNE THROMBOCYTOPENIC PURPURA

*Dr. Nikhilesh Andhi, J. Pravalika, V. Thulasi Prasanna and M. Surya Teja

ABSTRACT

Immune Thrombocytopenic Purpura (ITP) comprises a group of disorders characterized by an autoimmune-mediated destruction of platelets, leading to a decreased platelet count, inadequate platelet production and a proportionally increased risk of bleeding. Overall, ITP is more frequent in women, Objectives: evaluate the safety and efficacy of Romiplostim in the treatment of Immune Thrombocytopenic Purpura, assess the incidence of ITP. Methodology: A prospective observational study was conducted in General medicine departments (OPD, IPD) of tertiary care hospital. The data was collected from the departments after considering inclusion & exclusion criteria for a period of 6 months and a total of 97 patients were analysed with data collection forms Result: We have collected 97 cases of ITP and after applying Inclusion and Exclusion criteria; we got 70 cases that have a platelet count below 1 Lakh cells/cumm. The the incidence of ITP was observed more in females (68%) than males (32%), whereas prevalence of ITP was more among the age group 21-40 years (39.4%) and less in 61-80 years (9.1%).Based on duration of ITP Newly diagnosed cases were 21.2%, Chronic cases were 22.7% and the acute persistent cases were predominant with 56.06%. Chronic type of ITP is majorly seen in 0-20 years and 41-60 years age group i.e. 26.60% Romiplostim was chosen as a choice of treatment and we have followed up for 4 months. Out of 70 cases, 35 patients were given Romiplostim amongst which 4 patients were failed to attend regular follow-up. Among the remaining 35 patients, 12 patients were treated with only first line agents and 23 patients were given a combination of first line and second line agents other than Romiplostim. Conclusion: In conclusion through this study, the treatment of ITP 18% was on first line therapy, 35% are been provided with a combination therapy of first line and second line agents without Romiplostim. But most of the cases were treated with romiplostim (47%) due to their intolerant therapeutic outcome with the above therapies. Ten years through the introduction of romiplostim there is evidence for short term and long-term treatment based studies stating not only general safety of chronic long-term use of these medications, but also persistent efficacy in majort. Of subjects.

Keywords: Immune Thrombocytopenic Purpura (ITP), Romiplostim, Platelet count.