PB0675 - Comparison of short-term efficacy, safety of glucocorticoids combined with different regimens of thrombopoietic agents in thetreatment of severe primary immune thrombocytopenia

Background: We often use a combination of therapies to treat severe ITP. Glucocorticoids combined with rh-TPO have been shown to have better efficacy compared with glucocorticoids alone in severe ITP. It is unknown whether glucocorticoids combined with TPO-RA can also rapidly raise platelet counts and reduce the risk of bleeding, and which of these three regimens is more advantageous.

Aims: Comparison of the short-term efficacy and safety of glucocorticoids alone (glucocorticoids group), glucocorticoid+rh-TPO (rh-TPO group), and glucocorticoids+TPO-RA (TPO-RA group) in the treatment of severe ITP, and in order to provide a basis for choosing a safe and effective regimen.

Methods: Patients with severe ITP using these three treatment regimens were selected from January 1, 2021 to October 31, 2023. The general informations and treatment data was collected.

Results: Eighty-eight cases were included, the clinical characteristics of the three groups were no statistically significant difference (Table 1).The short-term overall rates of the three treatments were similar (p=0.175, Table 2).The time to initial response was faster in the rh-TPO group than in the glucocorticoids group and TPO-RA groups[2(1-4)d vs 3(1-8)d, p=0.005. 2(1-4)d vs 3(1-12) d, p=0.028] (Table 2). Peak platelet counts and maximum platelet counts increase in the rh-TPO group were both higher than in the glucocorticoids group[77(52-237)×109/L vs 57(24-290)×109/L,p=0.008. 79(47-234)×109/L vs 54.5(15-288)×109/L,p=0.008] (Table 2).Time to peak platelet and adverse reactions were no statistically different in the three groups(Table 2).

Conclusion(s): Glucocorticoids combined with rh-TPO can raise platelets to safe levels more quickly in severe ITP, the efficience is better than glucocorticoids combined with TPO-RA and glucocorticoidss alone, but glucocorticoids combined with TPO-RA and glucocorticoidss alone have similar efficacy.