Practical Considerations for ITP Therapy Selection and Future Research

EP: 1.Understanding Immune Thrombocytopenia: Pathophysiology, Classification, and Differentiation

EP: 2.Diagnostic and Patient Education Strategies in ITP

EP: 3.Managing Bleeding Risk in Patients with ITP

EP: 4.Living with ITP: Impact of Fatigue and Other Symptoms on Patients’ Quality of Life

EP: 5.Tailoring Care in ITP Through a Health Equity Lens

EP: 6.Looking Ahead in ITP: Addressing Unmet Needs and Embracing Innovation

EP: 7.Key Clinical Signs and Symptoms Used in Diagnosis of Immune Thrombocytopenia

EP: 8.Clinical Decision-Making in ITP: Timing Treatment Initiation and Therapy Goals

EP: 9.Current Treatment Algorithm for Management of Immune Thrombocytopenia

EP: 10.Addressing the Limitations of Current ITP Therapies

EP: 11.Risks versus Benefits: ITP Treatment Side Effects and the Influence on Patients’ Quality of Life

EP: 12.Defining Treatment Success, Failure, and When to Reassess Patients’ Management of ITP

EP: 13.Navigating Refractory ITP: Clinical Insights and Treatment Strategies

EP: 14.Potential Impact of Emerging Therapies on Patients Living with ITP

EP: 15.Emerging Agents Reshaping the ITP Landscape

EP: 16.Understanding Gaps and Limitations in Current ITP Therapies

EP: 17.LUNA 3 Trial Evaluation: Understanding BTK Inhibition in ITP Management

EP: 18.Defining the Role of Rilzabrutinib in ITP Management

EP: 19.The Value of Patient-Reported Outcomes in Choosing ITP Therapies

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EP: 20.Practical Considerations for ITP Therapy Selection and Future Research

Treatment selection for individuals with immune thrombocytopenia (ITP) requires careful consideration of patient-specific factors, including comorbidities, age, administration practicality, and treatment adherence patterns. Real-world experience demonstrates that even effective therapies can fail when practical barriers prevent consistent administration—exemplified by patients who discontinue weekly injection regimens despite achieving platelet responses. The burden of frequent clinic visits for infusions or injections disproportionately affects individuals managing work obligations, caregiving responsibilities, or transportation challenges, ultimately compromising treatment effectiveness regardless of pharmacologic merit.

Rilzabrutinib’s oral formulation and multitargeted immunomodulation mechanism offer practical advantages addressing these real-world adherence challenges. Patients gain autonomy through pharmacy-based access and self-administered twice-daily dosing without requiring health care facility visits for drug administration. This convenience particularly benefits individuals in rural areas, those with limited mobility, or patients whose work schedules conflict with frequent clinic appointments. The therapy’s unique mechanism targeting fundamental immune dysregulation rather than simply stimulating platelet production represents a mechanistic advancement complementing its practical administration benefits.

Long-term efficacy and safety data will strengthen confidence in rilzabrutinib’s role for individuals requiring extended ITP management. Although experience with earlier Bruton tyrosine kinase (BTK) inhibitors in blood cancers showed some toxicities, such as hypertension escalating with prolonged exposure, rilzabrutinib’s covalent reversible binding and greater BTK specificity suggest a different profile. However, systematic long-term follow-up remains essential for fully characterizing sustained benefit and any time-dependent safety signals. Patient education distinguishing rilzabrutinib’s unique pharmacologic properties from earlier-generation BTK inhibitors helps individuals make informed decisions. The therapy’s promise lies in delivering both quantitative platelet improvements and qualitative enhancements in daily functioning, representing comprehensive benefit for patients whose ITP management previously required accepting trade-offs between disease control and quality of life.