PMID- 29582213
OWN - NLM
STAT- MEDLINE
DCOM- 20181019
LR  - 20190701
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Print)
IS  - 0929-5305 (Linking)
VI  - 46
IP  - 1
DP  - 2018 Jul
TI  - Management of antithrombotic therapy in adults with immune thrombocytopenia 
      (ITP): a survey of ITP specialists and general hematologist-oncologists.
PG  - 24-30
LID - 10.1007/s11239-018-1649-7 [doi]
AB  - While patients with immune thrombocytopenia (ITP) and low platelet counts are at 
      risk for bleeding, they are not protected against arterial and venous thrombotic 
      events. Frequently, hematologists are asked to consult on a patient with ITP 
      requiring an antiplatelet (AP) agent or anticoagulant (AC). No direct evidence 
      exists to guide hematologists in weighing the risk of thrombosis against the risk 
      of bleeding in patients with ITP. Therefore, we performed a survey to determine 
      the preferred management of AP/AC therapy in ITP patients. The survey described 
      hypothetical patient scenarios and asked respondents to recommend a minimum 
      platelet count for initiation of AP/AC therapy. We surveyed both hematologists 
      with an international reputation in treatment of ITP (n = 48) and also general 
      hematologist-oncologists in Oklahoma (n = 97). Response rates were 38/48 (79%) 
      for the ITP specialists and 46/97 (47%) for general hematologist-oncologists. 
      Overall, recommended platelet thresholds for antithrombotic therapy were similar 
      between ITP specialists and general hematologist-oncologists. Although both 
      groups recommended a minimum platelet count of 50 x 10(9)/L for AP and AC therapy 
      in most scenarios, there was great variability in individual practice patterns 
      among respondents. This study highlights the need for studies of patients with 
      ITP who require AP/AC therapy to provide high-quality evidence for establishing 
      optimal management strategies.
FAU - Pishko, Allyson M
AU  - Pishko AM
AUID- ORCID: 0000-0001-9997-454X
AD  - Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 
      Philadelphia, PA, USA. allyson.pishko@uphs.upenn.edu.
FAU - Misgav, Mudi
AU  - Misgav M
AD  - National Hemophilia Center, Sheba Medical Center, Tel Aviv University, Ramat-Gan, 
      Israel.
FAU - Cuker, Adam
AU  - Cuker A
AD  - Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 
      Philadelphia, PA, USA.
AD  - Department of Pathology and Laboratory Medicine, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, PA, USA.
FAU - Cines, Douglas B
AU  - Cines DB
AD  - Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 
      Philadelphia, PA, USA.
AD  - Department of Pathology and Laboratory Medicine, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, PA, USA.
FAU - George, James N
AU  - George JN
AD  - Department of Medicine, College of Medicine, University of Oklahoma Health 
      Sciences Center, Oklahoma City, OK, USA.
AD  - Department of Biostatistics and Epidemiology, College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
FAU - Vesely, Sara K
AU  - Vesely SK
AD  - Department of Biostatistics and Epidemiology, College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
FAU - Terrell, Deirdra R
AU  - Terrell DR
AD  - Department of Biostatistics and Epidemiology, College of Public Health, 
      University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
LA  - eng
GR  - U54 GM104938/GM/NIGMS NIH HHS/United States
GR  - 1K01HL135466-01/National Heart, Lung, and Blood Institute/
GR  - K01 HL135466/HL/NHLBI NIH HHS/United States
GR  - HL 7971-16/National Heart, Lung, and Blood Institute/
GR  - T32 HL007971/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adult
MH  - Anticoagulants/therapeutic use
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Hematology
MH  - Humans
MH  - *Medication Therapy Management
MH  - Middle Aged
MH  - Oklahoma
MH  - Oncologists
MH  - Platelet Aggregation Inhibitors/adverse effects/therapeutic use
MH  - Platelet Count
MH  - Practice Patterns, Physicians'/standards
MH  - Purpura, Thrombocytopenic, Idiopathic/*drug therapy
MH  - Specialization
MH  - Surveys and Questionnaires
PMC - PMC6355248
MID - NIHMS1008292
OTO - NOTNLM
OT  - Anticoagulant therapy
OT  - Antiplatelet therapy
OT  - Antithrombotic therapy
OT  - ITP
OT  - Immune thrombocytopenia
COIS- Conflict of interest: AC has served as a consultant for Kedrion and Synergy and 
      has received research support from Bayer, Bioverativ, Novo Nordisk, Pfizer, 
      Shire, and Spark Therapeutics. DC has served as a consultant for Amgen, Bayer, 
      Rigel, Astellas and Ionis and has received research support from Syntimmune, 
      Momenta, T2 Biosystems and Sanofi.
EDAT- 2018/03/28 06:00
MHDA- 2018/10/20 06:00
PMCR- 2019/07/01
CRDT- 2018/03/28 06:00
PHST- 2018/03/28 06:00 [pubmed]
PHST- 2018/10/20 06:00 [medline]
PHST- 2018/03/28 06:00 [entrez]
PHST- 2019/07/01 00:00 [pmc-release]
AID - 10.1007/s11239-018-1649-7 [pii]
AID - 10.1007/s11239-018-1649-7 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2018 Jul;46(1):24-30. doi: 10.1007/s11239-018-1649-7.