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- W2893252316 endingPage "76" @default.
- W2893252316 startingPage "70" @default.
- W2893252316 abstract "Despite the improvement in understanding its pathogenesis and the introduction of novel treatment options, the management of primary immune thrombocytopenia (ITP) still remains challenging. Considering its increased incidence with aging and prolonged life-expectancy, ITP is often diagnosed in elderly patients, a subset that deserves some special precautions. Ensure the diagnosis is a crucial step, and carefully attention must be given in excluding other causes of thrombocytopenia, especially among older people that frequently suffer from many comorbidities. When it comes to treatment decision, it is worth keeping into account that the elderly have an increased risk of bleeding, thrombosis and infections, that they often require many concomitant therapies, including antiplatelet or anticoagulant agents, and that treatment-related toxicities are often increased and sometimes more dangerous that the disease itself. There are not dedicated guidelines, and only few specific studies. Steroids with or without IVIG remain the first-line treatment. Splenectomy is less effective than in youngers and burdened by an increased thrombotic and infectious risk. Rituximab is a good option in non-immunocompromised patients, but long-term remissions are few. Eltrombopag and romiplostim have a good safety and efficacy profile, and have become a prominent drug in this subset, even if they are associated with a possible increased risk of thrombosis, and long-term toxicity is unknown. Other drugs, such as dapsone and danazol, have a well-known efficacy and safety profile, and still represent a valid option among elderly patients." @default.
- W2893252316 created "2018-10-05" @default.
- W2893252316 creator A5008779503 @default.
- W2893252316 creator A5020570449 @default.
- W2893252316 creator A5039006383 @default.
- W2893252316 creator A5044096443 @default.
- W2893252316 date "2018-12-01" @default.
- W2893252316 modified "2023-10-06" @default.
- W2893252316 title "Management of immune thrombocytopenia in elderly patients" @default.
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