Fatigue in adult patients with primary immune thrombocytopenia

Newton, Julia L.; Reese, Jessica; Watson, Shirley; Vesely, Sara K.; Bolton‐Maggs, Paula; George, James N.; Terrell, Deirdra R.

doi:10.1111/j.1600-0609.2011.01587.x

Cited by 82 publications

(120 citation statements)

References 40 publications

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“…Additionally, patients with lower WHO bleeding scores reported higher HRQoL scores as measured using the SF-36v2, the FACIT-Fatigue, and the FACT-Th6 instruments. This is consistent with a recent study demonstrating an association between fatigue and the presence of bleeding symptoms 21 . It is not known if these correlations would permit the use of a simpler scale to assess and monitor bleeding in patients with chronic ITP in the clinic; however, these correlations further support the accuracy and sufficiency of the simpler WHO Bleeding Scale to assess and monitor bleeding and bruising in adult patients with chronic ITP.…”

Section: Who Bleeding Scalesupporting

confidence: 93%

Selective validation of the WHO Bleeding Scale in patients with chronic immune thrombocytopenia

Fogarty

Tarantino

Brainsky

et al. 2011

Current Medical Research and Opinion

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Section: Who Bleeding Scalesupporting

confidence: 93%

Selective validation of the WHO Bleeding Scale in patients with chronic immune thrombocytopenia

Fogarty

Tarantino

Brainsky

et al. 2011

Current Medical Research and Opinion

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“…Almost 70% of patients ( n = 25) suffered from fatigue, with only one control indicating such. One study investigating fatigue in adult primary AITP highlighted the clinical importance of this symptom [43]. In accordance with the findings of this study, chronic fatigue syndrome (CFS) occurs four times more frequently in women than in men, with CFS patients demonstrating signs of OS [44].…”

Section: Discussionsupporting

confidence: 83%

Oxidative Stress Is Predominant in Female but Not in Male Patients with Autoimmune Thrombocytopenia

Kamhieh-Milz

Salama

2014

Oxidative Medicine and Cellular Longevity

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As the involvement of oxidative stress (OS) in autoimmune thrombocytopenia (AITP) has been reported, a fast and rapid test for the reliable measurement of OS and antioxidant capacities (AOCs) might be a useful tool in extending current diagnostic possibilities. The free oxygen radical test (FORT) and free oxygen radical defence (FORD) assay (Callegari, Italy) are easy to perform and reliable, with results available within 15 minutes. Thirty-seven AITP patients and 37 matched healthy individuals were included in this study. All participants responded to a standard questionnaire provided by these assays. Female patients with AITP were observed to demonstrate significantly higher OS in comparison to female controls (P = 0.0027) and male AITP patients (P = 0.0018). The AOCs were not reduced in patients with AITP (P = 0.7648). Correlation of OS with platelet count identified a weak positive correlation (P = 0.0327, Spearman R = 0.4672). The questionnaire revealed that ITP patients in comparison to healthy controls are more stressed, feel exhausted and fatigued, and eat a healthier diet. In conclusion, OS is predominant in female but not in male patients with AITP suggesting gender-specific differences in the pathomechanisms of AITP. Identification of patients with high levels of OS might be beneficial in the management of AITP.

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“…For example, fatigue is now a well-characterized phenomenon in ITP. We and others [17,18,19] have observed that fatigue predominantly occurs when platelet counts decrease to < 50,000/µl in most affected patients. Comparison of adverse reactions in patients either receiving drugs or a placebo has demonstrated that the difference between both groups is insignificant.…”

Section: Discussionmentioning

confidence: 90%

Thrombopoietin Receptor Agonists Are Often Ineffective in Immune Thrombocytopenia and/or Cause Adverse Reactions: Results from One Hand

Depré

Aboud

Ringel

et al. 2016

Transfus Med Hemother

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Background: Eltrombopag and romiplostim are thrombopoietin receptor agonists (TPOs) that have been increasingly used for the treatment of immune thrombocytopenia (ITP). Based on our experience, the incidence of abortive treatment with these drugs and the occurrence of adverse reactions that lead to therapy break-off despite response are higher than has been previously suggested. Methods: During the last 8 years, a total of 65 patients were treated with eltrombopag and/or romiplostim at our institute. Results: 36 of a total of 58 patients responded well to eltrombopag. In 12 patients that responded, treatment with eltrombopag was discontinued due to the development of adverse reactions. Eltrombopag was replaced by romiplostim in 23 cases (14 non-responders, 9 patients with adverse reactions). Of these patients, 83% responded to romiplostim. Among all patients treated with romiplostim (n = 32), 75% initially responded; however, 8 of these patients developed adverse reactions. Romiplostim was replaced by eltrombopag in 5 cases (4 due to adverse reactions, 1 non-responsive patient), and only 3 (60%) of these patients were observed to respond to eltrombopag. Conclusion: TPOs often remain ineffective in ITP or result in adverse reactions, which lead to treatment stop or to drug switch. Therefore, alternative treatment options are required.

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Fatigue in adult patients with primary immune thrombocytopenia

Abstract: Fatigue is a common symptom among patients with ITP. These data provide the basis for future studies to define the clinical importance of fatigue in ITP.

Cited by 82 publications

References 40 publications

Selective validation of the WHO Bleeding Scale in patients with chronic immune thrombocytopenia

Selective validation of the WHO Bleeding Scale in patients with chronic immune thrombocytopenia

Oxidative Stress Is Predominant in Female but Not in Male Patients with Autoimmune Thrombocytopenia

Thrombopoietin Receptor Agonists Are Often Ineffective in Immune Thrombocytopenia and/or Cause Adverse Reactions: Results from One Hand

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