Nplate thearpy

My husband has had his third ITP. Episode. The first two were treated with IVIG, platletts, and Prednizone successfully. He has nowhad his third episode, with all of the above showing no improvement in 2 weeks. He has been started on N-plate last week and just had his next dose of 6mcg. He has still shown no upswing in his platlets which are less than 5,000. They have not tried the Anti-D yet. Does anyone know how long it should normally take the N-Plate to kick in and what the next steps with dosing might be and/or what steps might be taken next if N-Plate is determined to be inaffective. Thanks for your help and advice. Shelly

It can take a few weeks for Nplate to start working. Protocol is to start at 1mcg per kg of body weight and work up by 1mcg/kg each week. Some get to dose 8 or 9 before getting anywhere but often after a while are able to come back down the doses again and use less. If there's no success at 10mg/kg then the drug is stopped.

Thank you so much Ann. it got 6 a few days ago and today for the first time his platletts went up to 9,000. here's to hoping that they still keep climbing. Thank you again. Shelly