Although upfront management of immune thrombocytopenia (ITP) in adults has not changed much over the years, advances in the treatment of refractory ITP have some clinicians looking for guidance. In 2018, the FDA approved fostamatinib (Tavalisse) as a second-line treatment for adults with chronic ITP, making it the first new drug marketed for adults with ITP since approvals of romiplostim (Nplate) and eltrombopag (Promacta) a decade earlier. The FDA is also considering a request to expand indications for avatrombopag (Doptelet) to include refractory ITP in adults, with a decision expected by June 30, 2019.
- By Christin L. Melton, ELS