Vol. 2 No. 6 (2022)
Health Technology Reviews

Guidelines for Pediatric Immune Thrombocytopenia

Published June 1, 2022

Key Messages

  • 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.