Management of ITP: Including Approach in Refractory Patients in Children and Adults

Immune thrombocytopenia (ITP) is characterized by immune-mediated platelet destruction. While first-line treatment options such as corticosteroids and IVIG are effective initially, relapse and chronicity affect most adults. This review evaluates current studies in the management of chronic ITP, both paediatric and adult, with a focus on refractory cases. Second-line therapies, including splenectomy, rituximab, thrombopoietin receptor agonists (TPO-RAs), fostamatinib, and other immunosuppressives, are reviewed.