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Published on: October 25, 2024
Rescue therapy with romiplostim for refractory primary immune thrombocytopenia during pregnancy
Justine Decroocq1, Louis Marcellin, Camille Le Ray
1Unité Fonctionnelle d'Hématologie and Département d'Obstétrique et de Gynécologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, and Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.
Background:
Primary immune thrombocytopenia is not a rare event during pregnancy, and it must be carefully managed to avoid hemorrhagic complications for the mother. After failure of first-line treatments, the teratogenicity and toxicity of other therapeutic agents limit the available options and treatment.
Cases:
We describe the cases of two pregnant patients with corticosteroid-refractory immune thrombocytopenia who were successfully treated by romiplostim, a thrombopoietin receptor agonist, without any fetal or maternal complications.
Conclusion:
Romiplostim may represent an important alternative treatment choice during pregnancy for immune thrombocytopenia cases refractory to first-line therapy, especially because of its speed of action and high efficacy. Nevertheless, further data are required to provide definitive evidence of its safety for newborns.
