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Review

Addressing thrombosis concerns in immune thrombocytopenia: the role of fostamatinib in immune thrombocytopenia management

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Pages 55-66 | Received 06 Jun 2023, Accepted 09 Feb 2024, Published online: 19 Feb 2024

Figures & data

Figure 1. A simplified depiction of the ITP pathogenesis along with the sites of intervention for new therapeutics (from Provan and Semple [Citation1]).

Figure 1. A simplified depiction of the ITP pathogenesis along with the sites of intervention for new therapeutics (from Provan and Semple [Citation1]).

Table 1. Pro-thrombotic factors in ITP.

Figure 2. (a) the incidence of ITP in France (2009–2011). white bars = females diagnosed with ITP; black bars = males diagnosed with ITP. Asterisks denote statistically significant differences between the sexes (from moulis et al. [Citation56]). (b) The percentage of ITP cases which were secondary to other conditions with age in France (2009-2011). (From Moulis et al. [Citation56]). (c) Gastrointestinal and central nervous system bleeds in ITP patients by age. White bars = gastrointestinal bleeds; black bars = central nervous system bleeds. There was a statistically significant correlation between gastrointestinal bleed bleeds and age (p = 0.003) and central nervous system bleeds and age (p = 0.02). (From Moulis et al. [Citation56]).

Figure 2. (a) the incidence of ITP in France (2009–2011). white bars = females diagnosed with ITP; black bars = males diagnosed with ITP. Asterisks denote statistically significant differences between the sexes (from moulis et al. [Citation56]). (b) The percentage of ITP cases which were secondary to other conditions with age in France (2009-2011). (From Moulis et al. [Citation56]). (c) Gastrointestinal and central nervous system bleeds in ITP patients by age. White bars = gastrointestinal bleeds; black bars = central nervous system bleeds. There was a statistically significant correlation between gastrointestinal bleed bleeds and age (p = 0.003) and central nervous system bleeds and age (p = 0.02). (From Moulis et al. [Citation56]).

Figure 3. An algorithm for selection of second-line treatment for ITP.

This treatment algorithm was developed considering an ITP patient who has developed a thrombosis.
Figure 3. An algorithm for selection of second-line treatment for ITP.

Figure 4. Fostamatinib mechanism of action. inhibition of spleen tyrosine kinase (SYK) by fostamatinib plays a key role in antibody-mediated phagocytosis of platelets.

Figure 4. Fostamatinib mechanism of action. inhibition of spleen tyrosine kinase (SYK) by fostamatinib plays a key role in antibody-mediated phagocytosis of platelets.

Figure 5. Pro-inflammatory and pro-coagulation pathways affected by spleen tyrosine kinase (SYK). Fcγ = fragment, crystallizable region; IgG = immunoglobulin G; P = phosphoryl group (from Cooper et al. [Citation8]).

Figure 5. Pro-inflammatory and pro-coagulation pathways affected by spleen tyrosine kinase (SYK). Fcγ = fragment, crystallizable region; IgG = immunoglobulin G; P = phosphoryl group (from Cooper et al. [Citation8]).