Guidelines for Pediatric Immune Thrombocytopenia

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Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1426-000

Question

  1. What are the evidence-based guidelines regarding dapsone for pediatric patients with immune thrombocytopenia?
  2. What are the evidence-based guidelines regarding rituximab for pediatric patients with immune thrombocytopenia?
  3. What are the evidence-based guidelines regarding thrombopoietin receptor agonists for pediatric patients with immune thrombocytopenia?

Key Message

Three guidelines included in this report recommend rituximab, thrombopoietic agents (drugs that promote platelet growth), and thrombopoietin receptor agonists (e.g., romiplostim, eltrombopag) over splenectomy as second-line treatment in children with immune thrombocytopenia who do not respond to first-line treatment.

Three guidelines included in this report recommend for children with persistent or chronic immune thrombocytopenia who have no response to 1 thrombopoietin receptor agonist or who lose an initial response that treatment can be switched to another thrombopoietin receptor agonist and/or combined with mycophenolate mofetil or another immunosuppressant. For individuals who do not respond to thrombopoietin receptor agonists, the recommendation is to consider rituximab and dexamethasone, especially for adolescent females.

No relevant evidence-based recommendation was identified regarding the use of dapsone for the treatment of children with immune thrombocytopenia.