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  Relative Thrombopoietin Deficiency: Part of the Dual Challenge  in Chronic Immune Thrombocytopenic Purpura (ITP)
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ITP, a rare bleeding disorder, has long been described as a disease of platelet destruction. However, recent research has revealed an additional factor involved in  the pathophysiology of ITP: suboptimal platelet production  due in large part to a relative thrombopoietin (TPO) deficiency. Dr. Ralph Boccia will discuss the mechanisms leading to relative TPO deficiency in chronic ITP, as well as a novel treatment approach to address the dual challenge of this disease.

Maurice Pickard, MD
Fellow, MacLean Center for Clinical Medical Ethics
University of Chicago
Chicago, IL

Ralph V. Boccia, MD, FACP
Clinical Associate Professor
of Medicine
Georgetown University Washington, DC
Nplate® is indicated for the treatment of thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulins or splenectomy. Nplate® should be used only in patients with ITP whose degree of thrombocytopenia and clinical condition increases the risk for bleeding. Nplate® should not be used in an attempt to normalize platelet counts.
Serious adverse reactions associated with Nplate® in clinical studies were bone marrow reticulin deposition and worsening thrombocytopenia after Nplate® discontinuation. Additional risks include Bone Marrow Fibrosis, Thrombotic/Thromboembolic Complications, Lack or Loss of Response to Nplate®, Hematological Malignancies and Progression of Malignancy in Patients with a Pre-existing Hematological Malignancy or Myelodysplastic Syndrome (MDS).

Nplate® is not indicated for the treatment of thrombocytopenia due to MDS or any cause of thrombocytopenia other than chronic ITP.

Monitor CBC’s, including platelet counts and peripheral blood smears, prior to initiation, throughout, and following discontinuation of Nplate® therapy.

Nplate® is available only through a restricted distribution program called Nplate® NEXUS (Network of Experts Understanding and Supporting Nplate and Patients) Program.

In the placebo-controlled studies, headache was the most commonly reported adverse drug reaction.

Click here for Prescribing Information and Medication Guide.
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