Management of Adult Patients with Primary Immune Thrombocytopenia (ITP) in Clinical Practice: A Consensus Approach of the Spanish ITP Expert Group

Autor: Jose María Guinea de Castro, M. Fernanda López-Fernández, Maria Luisa Lozano, M. Teresa Álvarez Román, Blanca Sánchez González, Tomás José González-López, Luis Fernando Fernández Fuertes, Isidro Jarque, David Valcárcel Ferreiras, Jose Ramon Gonzalez Porras, M. Eva Mingot-Castellano
Přispěvatelé: [Mingot-Castellano ME] Service of Hematology, Hospital Virgen del Rocio, Sevilla, Spain. [Álvarez Román MT] Service of Hematology, Hospital Universitario La Paz, Madrid, Spain. [Fernández Fuertes LF] Service of Hematology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain. [González-López TJ] Service of Hematology, Hospital Universitario de Burgos, Burgos, Spain. [Guinea de Castro JM] Service of Hematology and Hemotherapy, Universitario de Araba, Vitoria-Gasteiz, Álava, Spain. [Jarque I] Service of Hematology and Hemotherapy, Hospital Universitario y Politécnico La Fe, Valencia, Spain. [Valcárcel Ferreiras D] Unitat de Trasplantament de cèl•lules mare hematopoètiques, Vall d'Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Pediatrics
medicine.medical_specialty
Article Subject
MEDLINE
Delphi method
terapéutica::protocolos clínicos [TÉCNICAS Y EQUIPOS ANALÍTICOS
DIAGNÓSTICOS Y TERAPÉUTICOS]
Therapeutics::Clinical Protocols [ANALYTICAL
DIAGNOSTIC AND THERAPEUTIC TECHNIQUES
AND EQUIPMENT]
Likert scale
Equips d'especialistes
Trombocitopènia
hemic and lymphatic diseases
medicine
Diseases of the blood and blood-forming organs
Hemic and Lymphatic Diseases::Hematologic Diseases::Blood Platelet Disorders::Thrombocytopenia [DISEASES]
Hematologia
Response rate (survey)
Adult patients
business.industry
Hematology
enfermedades hematológicas y linfáticas::enfermedades hematológicas::trastornos de las plaquetas sanguíneas::trombocitopenia [ENFERMEDADES]
Expert group
Immune thrombocytopenia
Clinical Practice
Ciencias de la información::análisis de sistemas::técnica Delfos [CIENCIA DE LA INFORMACIÓN]
Information Science::Systems Analysis::Delphi Technique [INFORMATION SCIENCE]
Protocols clínics
RC633-647.5
business
Research Article
Zdroj: Advances in Hematology, Vol 2019 (2019)
Advances in Hematology
Scientia
ISSN: 1687-9112
1687-9104
Popis: Delphi method; Primary immune thrombocytopenia; Clinical guideline Método Delphi; Trombocitopenia inmune primaria; Guía clínica Consens Delphi; Trombocitopènia immune primària; Guia clínica Background and Objective. Diagnosis and management of primary immune thrombocytopenia (ITP) have changed dramatically in the last decade. Te aim of the study was to obtain information about the opinion of the Spanish ITP Group (GEPTI) members regarding the best clinical practices for diagnosis and management of adult patients with ITP. Materials and Methods. A tworound Delphi method was carried out by sending to 129 experts a 90-item questionnaire developed by 11 specialists, with a 4-point Likert scale (“never,” “sometimes,” “frequently,” and “always”) for the assessment of responses. Results. Forty out of the 129 experts participated in the survey (participation rate 30.2%) and 39 completed the questionnaire (response rate 97.5%). Salient consensus points included the following: the need to indicate workup studies from a sustained platelet count < 100 x 109 /L in the absence of a clear etiology; bone marrow aspiration in elderly patients with suspected ITP; beginning treatment in asymptomatic patients with a platelet count < 20 x 109 /L; not exceeding 6-7 weeks of corticosteroid therapy; switching from corticosteroids to one thrombopoietin receptor agonist (TRA); switching to other TRA or other options as combinations of them with immunosuppressive drugs in case of failure; how to reduce tapering TRA; treating patients with symptomatic persistent ITP and platelet count > 20 x 109 /L; and considering mucosal or severe bleeding as a basic criterion for hospital admission. Conclusions. Te present consensus document provides a reference framework for the management of patients with ITP in clinical practice. The present study was carried out with the logistic support of Novartis Farmacéutica, S.A.
Databáze: OpenAIRE
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