Thrombotic thrombocytopenic purpura medical therapy: Difference between revisions

	Thrombotic thrombocytopenic purpura Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Thrombotic thrombocytopenic purpura from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Peripheral Smear
Direct Coombs Test
von Willebrand Factor-cleaving Protease Activity
X-ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Thrombotic thrombocytopenic purpura medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Thrombotic thrombocytopenic purpura medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Thrombotic thrombocytopenic purpura medical therapy
CDC on Thrombotic thrombocytopenic purpura medical therapy
Thrombotic thrombocytopenic purpura medical therapy in the news
Blogs on Thrombotic thrombocytopenic purpura medical therapy
Directions to Hospitals Treating Thrombotic thrombocytopenic purpura
Risk calculators and risk factors for Thrombotic thrombocytopenic purpura medical therapy

VisualWikitext

Latest revision as of 17:02, 31 March 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

Overview

TTP is a medical emergency and requires prompt treatment. The mainstay of treatment for TTP is plasma exchange therapy. Surgery is recommended among all patients who develop TTP with no responsr to medical therapy.

Medical Therapy

Patients with TTP are treated with daily plasma therapy.^[1]
Patients with TTP are treated with rituximab to prevent complications.^[1]
Vincristine (VCR) is a agent to treat TTP patients resistant to conventional plasma exchange (PEX) and pharmacologic therapy.^[2]
Cyclosporine A ^[3]

TTP treatment

- Plasma therapy
  - Fresh frozen plasma(FFP) for patients who have inherited TTP
  - Plasma exchange(PEX) for patients who have acquired TTP
  - (1.53 plasma volume exchange for the first procedures, followed by 1.03 patient plasma volume thereafter)
- Steroids
  - Treatment of acquired TTP is high dose methylprednisolone
    - Methylprednisolone (10 mg/kg/day for 3 days and then 2.5 mg/kg/day), this dose is more efficacious than standard dose (1 mg/kg/day)
- Rituximab
  - Standard treatment(375 mg/m2 in 4 weekly doses)^[4]

References

↑ ^1.0 ^1.1 Joly, Bérangère S.; Coppo, Paul; Veyradier, Agnès (2017). "Thrombotic thrombocytopenic purpura". Blood. 129 (21): 2836–2846. doi:10.1182/blood-2016-10-709857. ISSN 0006-4971.
↑ Bobbio-Pallavicini E, Porta C, Centurioni R, Gugliotta L, Vianelli N, Tacconi F, Billio A, Ascari E (April 1994). "Vincristine sulfate for the treatment of thrombotic thrombocytopenic purpura refractory to plasma-exchange. The Italian Cooperative Group for TTP". Eur. J. Haematol. 52 (4): 222–6. PMID 8005232.
↑ Medina PJ, Sipols JM, George JN (September 2001). "Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome". Curr. Opin. Hematol. 8 (5): 286–93. PMID 11604563.
↑ Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ (August 2012). "Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies". Br. J. Haematol. 158 (3): 323–35. doi:10.1111/j.1365-2141.2012.09167.x. PMID 22624596.

Template:WH Template:WS

[JolyCoppo2017-1] 1.0 ^1.1 Joly, Bérangère S.; Coppo, Paul; Veyradier, Agnès (2017). "Thrombotic thrombocytopenic purpura". Blood. 129 (21): 2836–2846. doi:10.1182/blood-2016-10-709857. ISSN 0006-4971.

[pmid8005232-2] Bobbio-Pallavicini E, Porta C, Centurioni R, Gugliotta L, Vianelli N, Tacconi F, Billio A, Ascari E (April 1994). "Vincristine sulfate for the treatment of thrombotic thrombocytopenic purpura refractory to plasma-exchange. The Italian Cooperative Group for TTP". Eur. J. Haematol. 52 (4): 222–6. PMID 8005232.

[pmid11604563-3] Medina PJ, Sipols JM, George JN (September 2001). "Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome". Curr. Opin. Hematol. 8 (5): 286–93. PMID 11604563.

[pmid22624596-4] Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ (August 2012). "Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies". Br. J. Haematol. 158 (3): 323–35. doi:10.1111/j.1365-2141.2012.09167.x. PMID 22624596.

[1]

[2]

[3]

[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Xyz}}
+{{Thrombotic thrombocytopenic purpura}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}} {{S.G.}}
 ==Overview==
-There is no treatment for [disease name]; the mainstay of therapy is supportive care.
+TTP is a [[medical]] [[emergency]] and requires [[prompt]] treatment. The mainstay of treatment for TTP is [[Blood plasma|plasma]] exchange [[therapy]]. Surgery is recommended among all patients who develop TTP with no responsr to [[medical]] [[therapy]].
-OR
-Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
-OR
-The majority of cases of [disease name] are self-limited and require only supportive care.
-OR
-[Disease name] is a medical emergency and requires prompt treatment.
-OR
-The mainstay of treatment for [disease name] is [therapy].
-OR
-The optimal therapy for [malignancy name] depends on the stage at diagnosis.
-OR
-[Therapy] is recommended among all patients who develop [disease name].
-OR
-Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
-OR
-Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
-OR
-Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
-OR
-Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
 ==Medical Therapy==
-*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
+*[[Patient|Patients]] with TTP are treated with daily [[Plasma|plasm]]<nowiki/>a [[Therapy|therap]]<nowiki/>y.<ref name="JolyCoppo2017">{{cite journal|last1=Joly|first1=Bérangère S.|last2=Coppo|first2=Paul|last3=Veyradier|first3=Agnès|title=Thrombotic thrombocytopenic purpura|journal=Blood|volume=129|issue=21|year=2017|pages=2836–2846|issn=0006-4971|doi=10.1182/blood-2016-10-709857}}</ref>
-*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
+*[[Patient|Patients]] with TTP are treated with [[rituximab]] to [[Prevention|prevent]] [[Complication (medicine)|complication]]<nowiki/>s.<ref name="JolyCoppo2017" />
-*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
+*[[Vincristine]] (VCR) is a agent to treat TTP [[Patient|patients]] resistant to [[Conventional medicine|conventional]] [[plasma]] [[Exchange transfusion|exchange]] (PEX) and [[pharmacologic]] [[therapy]].<ref name="pmid8005232">{{cite journal |vauthors=Bobbio-Pallavicini E, Porta C, Centurioni R, Gugliotta L, Vianelli N, Tacconi F, Billio A, Ascari E |title=Vincristine sulfate for the treatment of thrombotic thrombocytopenic purpura refractory to plasma-exchange. The Italian Cooperative Group for TTP |journal=Eur. J. Haematol. |volume=52 |issue=4 |pages=222–6 |date=April 1994 |pmid=8005232 |doi= |url=}}</ref>
-*Patients with TTP are treated with daily plasma therapy PEX(1.53 plasma volume exchange for the first procedures, followed by 1.03 patient plasma volume thereafter)<ref name="JolyCoppo2017">{{cite journal|last1=Joly|first1=Bérangère S.|last2=Coppo|first2=Paul|last3=Veyradier|first3=Agnès|title=Thrombotic thrombocytopenic purpura|journal=Blood|volume=129|issue=21|year=2017|pages=2836–2846|issn=0006-4971|doi=10.1182/blood-2016-10-709857}}</ref>
+*[[Cyclosporine]] A <ref name="pmid11604563">{{cite journal |vauthors=Medina PJ, Sipols JM, George JN |title=Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome |journal=Curr. Opin. Hematol. |volume=8 |issue=5 |pages=286–93 |date=September 2001 |pmid=11604563 |doi= |url=}}</ref>
-*Patients with TTP are treated with rituximab to prevent complications.<ref name="JolyCoppo2017" />
+===TTP treatment===
-===TTP===
-* '''1 Stage 1 - TTP'''
+**'''Plasma therapy'''
-**1 '''Plasma therapy'''
+*** [[Fresh frozen plasma]]([[Fresh frozen plasma|FFP]]) for [[Patient|patients]] who have [[inherited]] TTP
-*** 1.53 plasma volume exchange for the first procedures, followed by 1.03 patient plasma volume thereafter)
+*** [[Plasma]] [[Exchange transfusion|exchange]](PEX) for [[Patient|patients]] who have [[Acquired disorder|acquired]] TTP
+*** (1.53 [[plasma]] [[volume]] [[Exchange transfusion|exchange]] for the first procedures, followed by 1.03 [[patient]] [[plasma]] [[volume]] thereafter)
 ****
-**'''2 Steroids'''
+**'''Steroids'''
-***Treatment of acquired TTP is high-dose methylprednisolone
+***Treatment of [[acquired]] TTP is high [[dose]] [[methylprednisolone]]
-*****[[drug name|Methylprednisolone]] (10 mg/kg/day for 3 days and then 2.5 mg/kg/day), this dose is more efficacious than standard dose (1 mg/kg/day)
+**** [[drug name|Methylprednisolone]] (10 mg/kg/day for 3 days and then 2.5 mg/kg/day), this dose is more [[efficacious]] than [[standard]] [[dose]] (1 mg/kg/day)
-**'''3Rituximab'''
+**'''Rituximab'''
+*** [[Standard]] treatment(375 mg/m2 in 4 weekly [[Dose|doses]])'''<ref name="pmid22624596">{{cite journal |vauthors=Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ |title=Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies |journal=Br. J. Haematol. |volume=158 |issue=3 |pages=323–35 |date=August 2012 |pmid=22624596 |doi=10.1111/j.1365-2141.2012.09167.x |url=}}</ref>'''
 ==References==