CLINICAL THERAPEUTICS & HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCuneTreatment of primary and secondary immune thrombocytopeniaKado, Ruba; McCune, W. JosephAuthor Information Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, USA Correspondence to Ruba Kado, MD, Suite 7C27 North Ingalls Building, 300 North Ingalls SPC 5422, Ann Arbor, MI 48109-5422, USA. Tel: +1 734 232 6115; e-mail: [email protected] Current Opinion in Rheumatology: May 2019 - Volume 31 - Issue 3 - p 213-222 doi: 10.1097/BOR.0000000000000599 Buy Metrics Abstract Purpose of review Medical therapies for the treatment of immune thrombocytopenia (ITP) complicating SLE are increasingly being investigated as alternatives to splenectomy and IVIG. The purpose of this review is to highlight the therapies that are utilized in the treatment of primary ITP and ITP secondary to lupus. Recent findings Corticosteroids are still the standard initial treatment of ITP, with the addition of IVIG when a rapid response is needed. There are few studies dedicated to assessing the efficacy of disease-modifying antirheumatic (DMARD), biologic, and nonimmunosuppressive agents as treatment for lupus thrombocytopenia/lupus ITP. Rituximab and thrombopoeitin mimetics have been the most extensively studied therapies for primary ITP in recent years. Results of trials show adequate initial responses; however, the duration of therapy and sustainability of responses are variable. Splenectomy is less often utilized. Summary Although corticosteroids, intravenous immunoglobulin and splenectomy have proven to be effective measures to treat immune thrombocytopenia, newer studies have demonstrated positive outcomes of immunosuppressives and thrombopoeitin mimetics. In most cases, the reported duration of therapy was not prolonged. More studies are needed to fully assess the effect of medical therapy in lupus ITP and to determine how long to continue maintenance therapy. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.