期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 194, 期 5, 页码 822-834出版社
WILEY
DOI: 10.1111/bjh.17390
关键词
anticoagulation; antiplatelet; bleeding; thrombocytopenia; thrombosis
类别
Patients with immune thrombocytopenia (ITP) are at increased risk of developing venous and arterial thrombotic events, despite the primary aim of therapy being the prevention of bleeding. Limited evidence is available to guide clinicians in treating these complex cases.
Immune thrombocytopenia (ITP) is an autoimmune disorder in which a combination of defective platelet production and enhanced clearance leads to thrombocytopenia. The primary aim for therapy in patients with this condition is the prevention of bleeding. However, more recently, increased rates of venous and arterial thrombotic events have been reported in ITP, even in the context of marked thrombocytopenia. In this review we discuss the epidemiology, aetiology and management of thrombotic events in these patients. We consider the impact of ITP therapies on the increased thrombotic risk, in particular the use of thrombopoietin-receptor agonists (TPO-RAs), as well as factors inherent to ITP itself. We also discuss the limited evidence available to guide clinicians in the treatment of these complex cases.
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