Experience with the drug 5 % human normal immunoglobulin for intravenous administration of Ig Vena N.I.V. in the treatment of immune thrombocytopenic purpura in children

Thrombopoietin receptor agonists in pharmacotherapy of pediatric immune thrombocytopenia

“…Based on the literature data, approximately 70-80% of patients after using IVIG for 2-5 days have an increase in platelet count up to more than 50×10 9 /L, a complete remission occurs in half of the cases (Singh et al 2021). By the end of the first week of IVIG therapy, the platelet count reaches its maximum values; however, this is often temporary and persists only for 3-4 weeks, after which it may decrease to the initial level (Petrov 2016). The use of IVIG requires a long (5-8 hrs) infusion.…”

“…Currently, newly diagnosed pediatric ITP without severe hemorrhagic syndrome, due to the possibility of spontaneous remission during the first 2 months, are advised to be managed with observation tactics "watch and wait" (Petrov 2016;Cooper and Cines 2019;Neunert et al 2019;. The specific pharmacotherapy, first of all, is indicated for those patients who have a marked hemorrhagic syndrome and thrombocytopenia less than 20-30×10 9 /L (Rumyancev and Maschan 2015; Petrov 2016; .…”

“…The standard first-line drugs for newly diagnosed ITP treatment are glucocorticoids (GC) and intravenous immunoglobulins (IVIG) (Petrov 2016;Zotova et al 2017;Yasser et al 2020). First-line therapy for chronic ITP (cITP) treatment includes IVIG or anti-Rh-D immunoglobulin, second-line therapy includes GCs (Prednisolone, Dexamethasone, Methylprednisolone), immunosuppressants (Mycophenolate mofetil, Azathioprine, Cyclosporine, Cyclophosphamide, Vinblastine, etc.…”

“…GCs have a wide range of effects on immune cells (macrophages, T and B cells), Fc receptors, reducing platelet destruction. Approximately 70% of patients with GC therapy achieve a complete or partial platelet response in most cases during the first week of treatment (Petrov 2016), but often the response to therapy is unstable (Zotova et al 2018).…”

“…(IVIG) are polyspecific IgG drugs, the mechanism of action of which is associated with an increase in the functional activity of Tregs and blockade of macrophage Fc receptors, which reduces the platelet opsonization by autoantibodies and prevents their destruction by spleen macrophages (Petrov 2016). Besides, IVIG can block neonatal Fc receptors on the endotheliocyte surface and accelerate antiplatelet antibody catabolism (Shabanov and Vorobyova 2020).…”