used to encourage prescribers to consider the lowest possible effective dose. 56 Condition name The term Immune thrombocytopenia, rather than idiopathic (autoimmune Agreed - the condition name thrombocytopenic purpura is now more favoured. When I search for ITP under dose it does has been changed to Immune not come up. I needed to write idiopathic Thrombocytopenic Purpura for conditions relating to both children and adults. 57 Qualifying criteria Refractory acute ITP - initial therapy In the absence of bleeding, 14 Statement: days is thought to be a safe There has been no improvement in response to conventionaI doses of corticosteroid period for response to steroid therapy for at least treatment. If the patient is 14 days (unless valid reason is provided) bleeding, this would be a valid Comment: reason to prescribe Ig in less 14 days is too long to wait for a response to steroids, especially if the platelet count is <10. than 14 days which is Suggest 5 days instead supported by the criteria and the BloodSTAR system. 58 Qualifying criteria ITP with life-threatening haemorrhage or the potential for life- threatening haemorrhage In the absence of bleeding, 14 Statement: days is thought to be a safe When conventional doses of corticosteroids (for at least 14 days) have failed to improve period for response to steroid count (unless a valid reason is provided) treatment. If the patient is Comment: bleeding, this would be a valid 14 days is too long to wait for a response to steroids, especially if the platelet count is <10. reason to prescribe Ig in less Suggest 5 days instead than 14 days which is supported by the criteria and the BloodSTAR system. 59 Qualifying criteria Refractory acute ITP -splenectomy failed or contra indicated and second-line agent The Criteria for clinical unsuccessful response has been revised Statement: including extending the At least a two-fold increase in platelet count (and platelet count >30x109/L) was timeframe before demonstrated within 72 hours of previous immunoglobulin (lg) treatment improvement in platelet count
used to encourage prescribers to consider the lowest possible effective dose. 56 Condition name The term Immune thrombocytopenia, rather than idiopathic (autoimmune thrombocytopenic purpura is now more favoured. When I search for ITP under dose it does not come up. I needed to write idiopathic Agreed - the condition name has been changed to Immune Thrombocytopenic Purpura for conditions relating to both children and adults. 57 Qualifying criteria Refractory acute ITP - initial therapy Statement: There has been no improvement in response to conventionaI doses of corticosteroid therapy for at least 14 days (unless valid reason is provided) Comment: 14 days is too long to wait for a response to steroids, especially if the platelet count is <10. Suggest 5 days instead In the absence of bleeding, 14 days is thought to be a safe period for response to steroid treatment. If the patient is bleeding, this would be a valid reason to prescribe Ig in less than 14 days which is supported by the criteria and the BloodSTAR system. 58 Qualifying criteria ITP with life-threatening haemorrhage or the potential for life- threatening haemorrhage Statement: When conventional doses of corticosteroids (for at least 14 days) have failed to improve count (unless a valid reason is provided) Comment: 14 days is too long to wait for a response to steroids, especially if the platelet count is <10. Suggest 5 days instead In the absence of bleeding, 14 days is thought to be a safe period for response to steroid treatment. If the patient is bleeding, this would be a valid reason to prescribe Ig in less than 14 days which is supported by the criteria and the BloodSTAR system. 59 Qualifying criteria Refractory acute ITP -splenectomy failed or contra indicated and second-line agent unsuccessful Statement: At least a two-fold increase in platelet count (and platelet count >30x109/L) was demonstrated within 72 hours of previous immunoglobulin (lg) treatment The Criteria for clinical response has been revised including extending the timeframe before improvement in platelet count
feedback-to-the-proposed-changes-to-the-criteria-and-nba-responses2015-without-names.docx