Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul 9;8(13):3578-3582.
doi: 10.1182/bloodadvances.2023012541.

The 2022 review of the 2019 American Society of Hematology guidelines on immune thrombocytopenia

Cindy E Neunert  1 , Donald M Arnold  2 , Rachael F Grace  3 , Thomas Kuhne  4 , Keith R McCrae  5 , Deirdra R Terrell  6
Affiliations
Review

The 2022 review of the 2019 American Society of Hematology guidelines on immune thrombocytopenia

Cindy E Neunert et al. Blood Adv. .

Abstract

The 2019 American Society of Hematology (ASH) guidelines for immune thrombocytopenia (ITP) included recommendations on the management of adults (recommendations 1-9) and children (recommendations 10-21) with primary ITP . We describe here the results of a review of the 2019 guidelines by a working group of experts requested by ASH to inform decision-making about the need for and timing of a guideline revision. An updated Medline and Embase search applied the same search terms as in the 2019 ASH guidelines, limited to systematic reviews and clinical trials, from May 2017 to July 2022. There were 193 studies identified, 102 underwent abstract reviews, and 54 full reviews. Each study was assessed based on relevance to the previous recommendation with regard to the population, prioritized outcomes, new outcomes, and study design. Reviewers assessed if the data would change the strength or the directionality of the existing recommendation or merit development of a new recommendation. Based on this review, the ASH Committee on Quality endorsed a focused update on second-line management for adults with ITP. In addition, there will be continued annual monitoring and reviewing of the 2019 ASH guidelines on ITP in full to evaluate when there is sufficient new evidence to warrant additional revisions.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: C.E.N. has received research funding from Novartis; has served as a consultant to Novartis, Argenx, and Sanofi; received educational funding from Sobi; received royalties from UpToDate; has served as a medical adviser to UK ITP Support Association; and has voluntarily served ITP Australia. D.M.A. has received research funding from Novartis and Rigel; has served as a consultant to Novartis, Rigel, Amgen, Medison, Daiichi Sankyo, Sobi, Chugai, Principia, Takeda, Cellphire, Alpine, Argenx, and Sanofi; has received royalties from UpToDate; and has served as an honorary medical adviser to Platelet Disorders Support Association. R.F.G. has received research funding from Novartis, Sobi, and Agios; has served on the advisory board of Agios and Sanofi; and has served as an honorary medical adviser to Platelet Disorders Support Association. T.K. has received research funding from Amgen and Novartis; and has served on the advisory board of Argenx, Sobi, and UCB. K.R.M. has served on the data safety board of Argenex and has also served on the advisory board of Novartis and Alpine Bioscience. D.R.T. has served on the advisory board of Sanofi.

Figures

Figure 1.
Figure 1.
Literature search results.
See this image and copyright information in PMC

Comment in

References

    1. Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829–3866. - PMC - PubMed
    1. Neunert C, Lim W, Crowther M, Cohen A, Solberg L, Jr., Crowther MA, American Society of Hematology The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190–4207. - PubMed
    1. Arai Y, Matsui H, Jo T, Kondo T, Takaori-Kondo A. Efficacy of dexamethasone for acute primary immune thrombocytopenia compared to prednisolone: a systematic review and meta-analysis. TH Open. 2017;1(2):e73–e81. - PMC - PubMed
    1. Sadeghi A, Hosseini SF, Jouzdani SR. Evaluation of treatment plan by three-period pulses of high-dose dexamethasone among patients with primary immune thrombocytopenia on platelet count response and adverse events: a randomized clinical trial. J Res Med Sci. 2020;25:88. - PMC - PubMed
    1. Xiao Q, Lin B, Wang H, Zhan W, Chen P. The efficacy of high-dose dexamethasone vs. other treatments for newly diagnosed immune thrombocytopenia: a meta-analysis. Front Med (Lausanne) 2021;8 - PMC - PubMed

Publication types