A real-world study of immune thrombocytopenia management during the COVID-19 pandemic in the UK

Br J Haematol. 2022 Jan;196(2):351-355. doi: 10.1111/bjh.17804. Epub 2021 Aug 26.

Abstract

The COVID-19 pandemic has created many challenges in the management of immune thrombocytopenic purpura (ITP). The recommendation for avoidance of steroids by WHO led to the off-licence use, supported by NHS England, of thrombopoietin mimetics (TPO-RA) for newly diagnosed or relapsed ITP. This is a real-world prospective study which investigated the treatment patterns and outcomes in this setting. Twenty-four hospitals across the UK submitted 343 cases. Corticosteroids remain the mainstay of ITP treatment, but TPO-RAs were more effective. Incidental COVID-19 infection was identified in a significant number of patients (9·5%), while 14 cases were thought to be secondary to COVID-19 vaccination.

Keywords: COVID; coronavirus disease 2019; immune thrombocytopenia; platelets; thrombocytopenia.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoimmune Diseases / complications
  • COVID-19 / blood
  • COVID-19 / epidemiology*
  • COVID-19 Vaccines / adverse effects
  • Combined Modality Therapy
  • Comorbidity
  • Connective Tissue Diseases / complications
  • Contraindications, Drug
  • Disease Management
  • Female
  • Hemorrhage / epidemiology
  • Hemorrhage / etiology
  • Hospitals, District / statistics & numerical data
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Off-Label Use
  • Pandemics*
  • Platelet Transfusion
  • Prospective Studies
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Purpura, Thrombocytopenic, Idiopathic / epidemiology
  • Purpura, Thrombocytopenic, Idiopathic / etiology
  • Purpura, Thrombocytopenic, Idiopathic / therapy*
  • Tertiary Care Centers / statistics & numerical data
  • Thromboembolism / epidemiology
  • Thromboembolism / etiology
  • Thrombopoietin / agonists
  • Tranexamic Acid / therapeutic use
  • Treatment Outcome
  • United Kingdom / epidemiology
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • COVID-19 Vaccines
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Tranexamic Acid
  • Thrombopoietin