PB0340 - Treatment by Line in Patients With Persistent and Chronic Immune Thrombocytopenia, A Real-World Point-In-Time Study

Background: Primary immune thrombocytopenia (ITP) is an autoimmune, heterogenous haematological disorder characterised by a transient or persistent decrease in platelets without other underlying causes. Patients with chronic or persistent disease can receive multiple lines of treatment with potential adverse effects.

Aims: To explore real-world trends in ITP treatment, focusing on which treatments are used as first-, second- or subsequent lines of therapy, and the reasons for their choice.

Methods: Data were drawn from the Adelphi ITP Disease Specific Programme^TM (DSP), a real-world point-in-time study. Physicians were asked to complete attitudinal questionnaires and patient record forms for their next 1–5 consulting patients. Data collection occurred in six countries between August and September 2020. This analysis summarises treatment history and treatment rationale in patients with persistent (3–12 months) and chronic ( >12 months) ITP.

Results: A total of 124 physicians were surveyed, with data collected for 405 persistent and chronic patients. Of these (mean age: 52 years; 54% male; mean time since diagnosis [n=377]: 35.5 months), 307 (75.8%) were currently undergoing maintenance (chronic) therapy. Including both maintenance and acute (i.e., short-term treatment for a specific purpose) therapies, first-line treatment had been received by 389 patients, second-line by 271 patients, and third-line by 85 patients. Sixteen patients were not treated. Prednisolone was the most commonly prescribed first-line therapy (65%, n=253); eltrombopag was the most commonly prescribed second-line (36%, n=98) and third-line (41%, n=35) therapy (Figure 1). Efficacy was the main reason for treatment choice in first- and second-line treatments, specifically ‘improved platelet counts’ (n=188, 49%; n=150, 56%). At third-line, tolerability was most stated, specifically ‘to spare patients from steroids’ (n=39, 47%) (Figure 2).

Conclusion(s): Three quarters of persistent or chronic patients were receiving maintenance therapy. When progressing treatment lines, tolerability became an increasingly important reason for therapy choice. Adelphi ITP DSP is part-sponsored by UCB Pharma.