What is known and objective: Although thrombopoietin receptor agonists are a second-line treatment for refractory immune thrombocytopenia (ITP), we lack guidelines recommending maintenance modality in patients who achieve complete remission (CR).
Case summary: We report a patient with refractory ITP who achieved CR on romiplostim. Obtaining romiplostim for 6 months of therapy, we decided to try extending this by modifying the standard treatment regimen. Romiplostim was successfully administered 'on-demand', only if the patient's platelet count dropped below 150 × 109 /L, over a period of 12 months.
What is new and conclusion: The strategy of 'on-demand' therapy is a promising procedure for the maintenance of response, lowering costs and improving treatment safety.
Keywords: immune thrombocytopenia; thrombopoietin receptor agonists; ‘on-demand’ therapy.
© 2016 John Wiley & Sons Ltd.