{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:25:36Z","timestamp":1793330736335,"version":"4.5.0"},"reference-count":165,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The pathophysiology of immune thrombocytopenia (ITP) is complex and encompasses innate and adaptive immune responses, as well as megakaryocyte dysfunction. Rituximab is administered in relapsed cases and has the added benefit of inducing treatment-free remission in over 50% of patients. Nevertheless, the responses to this therapy are not long-lasting, and resistance development is frequent. B cells, T cells, and plasma cells play a role in developing resistance. To overcome this resistance, targeting these pathways through splenectomy and novel therapies that target Fc\u03b3R pathway, FcRn, complement, B cells, plasma cells, and T cells can be useful. This review will summarize the pathogenetic mechanisms implicated in rituximab resistance and examine the potential therapeutic interventions to overcome it. This review will explore the efficacy of established therapies, as well as novel therapeutic approaches and agents currently in development.<\/jats:p>","DOI":"10.3389\/fimmu.2023.1215216","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T13:42:15Z","timestamp":1690551735000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Rituximab resistance in ITP and beyond"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhengrui","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Murakhovskaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V94.3.909.415k02_909_913","article-title":"The incidence of idiopathic thrombocytopenic purpura in adults increases with age","volume":"94","author":"Frederiksen","year":"1999","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812","article-title":"Updated international consensus report on the investigation and management of primary immune thrombocytopenia","volume":"3","author":"Provan","year":"2019","journal-title":"Blood Adv"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021010968","article-title":"How I treat primary ITP in adult patients who are unresponsive to or dependent on corticosteroid treatment","volume":"137","author":"Ghanima","year":"2021","journal-title":"Blood"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.88a.20201","article-title":"Updated guidelines for immune thrombocytopenic purpura: Expanded management options","volume":"88","author":"DeSouza","year":"2021","journal-title":"Cleve Clin J Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-393975","article-title":"Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia","volume":"119","author":"Patel","year":"2012","journal-title":"Blood"},{"key":"B6","first-page":"1","article-title":"Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic purpura","volume":"38","author":"Harrington","year":"1951","journal-title":"J Lab Clin Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1179\/1607845412Y.0000000014","article-title":"The clinical significance of circulating B cells secreting anti-glycoprotein IIb\/IIIa antibody and platelet glycoprotein IIb\/IIIa in patients with primary immune thrombocytopenia","volume":"17","author":"Chen","year":"2012","journal-title":"Hematology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1172\/JCI153580","article-title":"High-affinity autoreactive plasma cells disseminate through multiple organs in patients with immune thrombocytopenic purpura","volume":"132","author":"Canales-Herrerias","year":"2022","journal-title":"J Clin Invest"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V70.4.1040.1040","article-title":"Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP","volume":"70","author":"McMillan","year":"1987","journal-title":"Blood"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V83.4.1024.1024","article-title":"Spectrum of Ig classes, specificities, and titers of serum antiglycoproteins in chronic idiopathic thrombocytopenic purpura","volume":"83","author":"He","year":"1994","journal-title":"Blood"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.248385","article-title":"FcgammaRI and FcgammaRIII on splenic macrophages mediate phagocytosis of anti-glycoprotein IIb\/IIIa autoantibody-opsonized platelets in immune thrombocytopenia","volume":"106","author":"Norris","year":"2021","journal-title":"Haematologica"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2011.01718.x","article-title":"Autoantibody-mediated complement activation on platelets is a common finding in patients with immune thrombocytopenic purpura (ITP)","volume":"88","author":"Najaoui","year":"2012","journal-title":"Eur J Haematol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13475","article-title":"Complement activation in patients with immune thrombocytopenic purpura according to phases of disease course","volume":"201","author":"Castelli","year":"2020","journal-title":"Clin Exp Immunol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07995.x","article-title":"Complement activation on platelets correlates with a decrease in circulating immature platelets in patients with immune thrombocytopenic purpura","volume":"148","author":"Peerschke","year":"2010","journal-title":"Br J Haematol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1985.tb07477.x","article-title":"Platelet-associated complement in chronic ITP","volume":"60","author":"Kurata","year":"1985","journal-title":"Br J Haematol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-08-2672","article-title":"Suppression of in vitro megakaryocyte production by antiplatelet autoantibodies from adult patients with chronic ITP","volume":"103","author":"McMillan","year":"2004","journal-title":"Blood"},{"key":"B17","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/nm.3770","article-title":"The Ashwell-Morell receptor regulates hepatic thrombopoietin production via JAK2-STAT3 signaling","volume":"21","author":"Grozovsky","year":"2015","journal-title":"Nat Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"7737","DOI":"10.1038\/ncomms8737","article-title":"Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia","volume":"6","author":"Li","year":"2015","journal-title":"Nat Commun"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.22211","article-title":"Relative efficacy of steroid therapy in immune thrombocytopenia mediated by anti-platelet GPIIbIIIa versus GPIbalpha antibodies","volume":"87","author":"Zeng","year":"2012","journal-title":"Am J Hematol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-06-009761","article-title":"Relative efficacy of intravenous immunoglobulin G in ameliorating thrombocytopenia induced by antiplatelet GPIIbIIIa versus GPIbalpha antibodies","volume":"108","author":"Webster","year":"2006","journal-title":"Blood"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2018.1513476","article-title":"Multirefractory primary immune thrombocytopenia; targeting the decreased sialic acid content","volume":"30","author":"Revilla","year":"2019","journal-title":"Platelets"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20951","article-title":"The role of autoantibody-producing plasma cells in immune thrombocytopenic purpura refractory to rituximab","volume":"82","author":"Kuwana","year":"2007","journal-title":"Am J Hematol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V87.10.4245.bloodjournal87104245","article-title":"Differences in serum cytokine levels in acute and chronic autoimmune thrombocytopenic purpura: relationship to platelet phenotype and antiplatelet T-cell reactivity","volume":"87","author":"Semple","year":"1996","journal-title":"Blood"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V78.10.2619.2619","article-title":"Increased antiplatelet T helper lymphocyte reactivity in patients with autoimmune thrombocytopenia","volume":"78","author":"Semple","year":"1991","journal-title":"Blood"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.007823","article-title":"Elevated profile of Th17, Th1 and Tc1 cells in patients with immune thrombocytopenic purpura","volume":"94","author":"Zhang","year":"2009","journal-title":"Haematologica"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2006.09.008","article-title":"Reduced Cd4+Cd25+ T cells in patients with idiopathic thrombocytopenic purpura","volume":"120","author":"Sakakura","year":"2007","journal-title":"Thromb Res"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1038\/nm921","article-title":"T-cell-mediated cytotoxicity toward platelets in chronic idiopathic thrombocytopenic purpura","volume":"9","author":"Olsson","year":"2003","journal-title":"Nat Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1038\/srep27445","article-title":"CD8(+) T cells induce platelet clearance in the liver via platelet desialylation in immune thrombocytopenia","volume":"6","author":"Qiu","year":"2016","journal-title":"Sci Rep"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12528","article-title":"Antibody binding to megakaryocytes in vivo in patients with immune thrombocytopenia","volume":"95","author":"Arnold","year":"2015","journal-title":"Eur J Haematol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.115634","article-title":"Immune thrombocytopenia: antiplatelet autoantibodies inhibit proplatelet formation by megakaryocytes and impair platelet production in vitro","volume":"100","author":"Iraqi","year":"2015","journal-title":"Haematologica"},{"key":"B31","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12935-019-0779-0","article-title":"Megakaryocytic dysfunction in immune thrombocytopenia is linked to autophagy","volume":"19","author":"Sun","year":"2019","journal-title":"Cancer Cell Int"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-02-139402","article-title":"Recruitment of T cells into bone marrow of ITP patients possibly due to elevated expression of VLA-4 and CX3CR1","volume":"112","author":"Olsson","year":"2008","journal-title":"Blood"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06737.x","article-title":"CD8+ T cells suppress autologous megakaryocyte apoptosis in idiopathic thrombocytopenic purpura","volume":"139","author":"Li","year":"2007","journal-title":"Br J Haematol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1206939","article-title":"Rituximab (monoclonal anti-CD20 antibody): mechanisms of action and resistance","volume":"22","author":"Smith","year":"2003","journal-title":"Oncogene"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.4161\/mabs.26008","article-title":"Lessons for the clinic from rituximab pharmacokinetics and pharmacodynamics","volume":"5","author":"Golay","year":"2013","journal-title":"MAbs"},{"key":"B36","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1365-2141.2010.08076.x","article-title":"The effect of rituximab on humoral and cell mediated immunity and infection in the treatment of autoimmune diseases","volume":"149","author":"Cooper","year":"2010","journal-title":"Br J Haematol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2016.053","article-title":"Rituximab in autoimmune diseases","volume":"39","author":"Randall","year":"2016","journal-title":"Aust Prescr"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04889.x","article-title":"The efficacy and safety of B-cell depletion with anti-CD20 monoclonal antibody in adults with chronic immune thrombocytopenic purpura","volume":"125","author":"Cooper","year":"2004","journal-title":"Br J Haematol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20276","article-title":"Rituximab chimeric anti-CD20 monoclonal antibody treatment for adult refractory idiopathic thrombocytopenic purpura","volume":"78","author":"Braendstrup","year":"2005","journal-title":"Am J Hematol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1182\/blood.v98.4.952","article-title":"Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura","volume":"98","author":"Stasi","year":"2001","journal-title":"Blood"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-005-0073-1","article-title":"Rituximab in the management of chronic immune thrombocytopenic purpura: an effective and safe therapeutic alternative in refractory patients","volume":"85","author":"Penalver","year":"2006","journal-title":"Ann Hematol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12206","article-title":"Lower dose rituximab is active in adults patients with idiopathic thrombocytopenic purpura","volume":"93","author":"Zaja","year":"2008","journal-title":"Haematologica"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12839","article-title":"Rituximab in immune thrombocytopenia: gender, age, and response as predictors of long-term response","volume":"98","author":"Marangon","year":"2017","journal-title":"Eur J Haematol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-582346","article-title":"Safety and efficacy of rituximab in adult immune thrombocytopenia: results from a prospective registry including 248 patients","volume":"124","author":"Khellaf","year":"2014","journal-title":"Blood"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24434","article-title":"Gender and duration of disease differentiate responses to rituximab-dexamethasone therapy in adults with immune thrombocytopenia","volume":"91","author":"Chapin","year":"2016","journal-title":"Am J Hematol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12587","article-title":"Response to rituximab in children and adults with immune thrombocytopenia (ITP)","volume":"5","author":"Harris","year":"2021","journal-title":"Res Pract Thromb Haemost"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00110","article-title":"Sirolimus as rescue therapy for refractory\/relapsed immune thrombocytopenia: results of a single-center, prospective, single-arm study","volume":"7","author":"Feng","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000272","article-title":"Suppression of normal immune responses after treatment with rituximab","volume":"28","author":"Kado","year":"2016","journal-title":"Curr Opin Rheumatol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abc3961","article-title":"Rituximab-resistant splenic memory B cells and newly engaged naive B cells fuel relapses in patients with immune thrombocytopenia","volume":"13","author":"Crickx","year":"2021","journal-title":"Sci Transl Med"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1172\/JCI65689","article-title":"B cell depletion in immune thrombocytopenia reveals splenic long-lived plasma cells","volume":"123","author":"Mahevas","year":"2013","journal-title":"J Clin Invest"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-789578","article-title":"BAFF and CD4(+) T cells are major survival factors for long-lived splenic plasma cells in a B-cell-depletion context","volume":"131","author":"Thai","year":"2018","journal-title":"Blood"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-12-129262","article-title":"Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab","volume":"112","author":"Stasi","year":"2008","journal-title":"Blood"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-02-068999","article-title":"Response to B-cell depleting therapy with rituximab reverts the abnormalities of T-cell subsets in patients with idiopathic thrombocytopenic purpura","volume":"110","author":"Stasi","year":"2007","journal-title":"Blood"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-03-491415","article-title":"Preferential splenic CD8(+) T-cell activation in rituximab-nonresponder patients with immune thrombocytopenia","volume":"122","author":"Audia","year":"2013","journal-title":"Blood"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.0376-2491.2014.38.014","article-title":"[Absence of response to rituximab in patients with refractory primary immune thrombocytopenia]","volume":"94","author":"Ma","year":"2014","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2018.6508","article-title":"Altered circulating T follicular helper cells in patients with chronic immune thrombocytopenia","volume":"16","author":"Dai","year":"2018","journal-title":"Exp Ther Med"},{"key":"B57","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1084\/jem.20130505","article-title":"Local BLyS production by T follicular cells mediates retention of high affinity B cells during affinity maturation","volume":"211","author":"Goenka","year":"2014","journal-title":"J Exp Med"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-03-563445","article-title":"Splenic TFH expansion participates in B-cell differentiation and antiplatelet-antibody production during immune thrombocytopenia","volume":"124","author":"Audia","year":"2014","journal-title":"Blood"},{"key":"B59","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s12185-017-2325-y","article-title":"Splenectomy vs. rituximab as a second-line therapy in immune thrombocytopenic purpura: a single center experience","volume":"107","author":"Al Askar","year":"2018","journal-title":"Int J Hematol"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23580","article-title":"Rituximab versus splenectomy in persistent or chronic adult primary immune thrombocytopenia: an adjusted comparison of mortality and morbidity","volume":"89","author":"Moulis","year":"2014","journal-title":"Am J Hematol"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.05.024","article-title":"Sequence of splenectomy and rituximab for the treatment of steroid-refractory immune thrombocytopenia: does it matter","volume":"94","author":"Hammond","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000488","article-title":"Retrospective analysis of rituximab therapy and splenectomy in childhood chronic and refractory immune thrombocytopenic purpura","volume":"27","author":"Ay","year":"2016","journal-title":"Blood Coagul Fibrinolysis"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e3282c8ca50","article-title":"Should rituximab be used before or after splenectomy in patients with immune thrombocytopenic purpura","volume":"14","author":"Cooper","year":"2007","journal-title":"Curr Opin Hematol"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520962348","article-title":"Efficacy and safety of rituximab for minors with immune thrombocytopenia: a systematic review and meta-analysis","volume":"48","author":"Qu","year":"2020","journal-title":"J Int Med Res"},{"key":"B65","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1615\/CritRevImmunol.2018025184","article-title":"The role of bruton's tyrosine kinase in immune cell signaling and systemic autoimmunity","volume":"38","author":"Rip","year":"2018","journal-title":"Crit Rev Immunol"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2016.1152888","article-title":"The role of Bruton's tyrosine kinase in autoimmunity and implications for therapy","volume":"12","author":"Crofford","year":"2016","journal-title":"Expert Rev Clin Immunol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.2217\/imt-2020-0215","article-title":"Fostamatinib: a review of its clinical efficacy and safety in the management of chronic adult immune thrombocytopenia","volume":"12","author":"Newland","year":"2020","journal-title":"Immunotherapy"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aax9586","article-title":"Blocking FcRn in humans reduces circulating IgG levels and inhibits IgG immune complex-mediated immune responses","volume":"5","author":"Blumberg","year":"2019","journal-title":"Sci Adv"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25125","article-title":"Fostamatinib for the treatment of adult persistent and chronic immune thrombocytopenia: Results of two phase 3, randomized, placebo-controlled trials","volume":"93","author":"Bussel","year":"2018","journal-title":"Am J Hematol"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25444","article-title":"Long-term fostamatinib treatment of adults with immune thrombocytopenia during the phase 3 clinical trial program","volume":"94","author":"Bussel","year":"2019","journal-title":"Am J Hematol"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3390\/cells11061003","article-title":"BTK inhibitors impair platelet-mediated antifungal activity","volume":"11","author":"Nasillo","year":"2022","journal-title":"Cells"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1021\/acs.jmedchem.1c01170","article-title":"Discovery of reversible covalent bruton's tyrosine kinase inhibitors PRN473 and PRN1008 (Rilzabrutinib)","volume":"65","author":"Owens","year":"2022","journal-title":"J Med Chem"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.749022","article-title":"Effects of the btk-inhibitors remibrutinib (LOU064) and rilzabrutinib (PRN1008) with varying btk selectivity over tec on platelet aggregation and in vitro bleeding time","volume":"8","author":"Duan","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.2001130","article-title":"Preclinical efficacy and anti-inflammatory mechanisms of action of the bruton tyrosine kinase inhibitor rilzabrutinib for immune-mediated disease","volume":"206","author":"Langrish","year":"2021","journal-title":"J Immunol"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2110297","article-title":"Rilzabrutinib, an oral BTK inhibitor, in immune thrombocytopenia","volume":"386","author":"Kuter","year":"2022","journal-title":"N Engl J Med"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.4161\/mabs.3.5.16983","article-title":"Neonatal Fc receptor and IgG-based therapeutics","volume":"3","author":"Kuo","year":"2011","journal-title":"MAbs"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002003","article-title":"Phase 2 multiple-dose study of an FcRn inhibitor, rozanolixizumab, in patients with primary immune thrombocytopenia","volume":"4","author":"Robak","year":"2020","journal-title":"Blood Adv"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25680","article-title":"Phase 2 study of efgartigimod, a novel FcRn antagonist, in adult patients with primary immune thrombocytopenia","volume":"95","author":"Newland","year":"2020","journal-title":"Am J Hematol"},{"key":"B79","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1182\/blood-2022-167838","article-title":"Efficacy and safety of intravenous efgartigimod in adults with primary immune thrombocytopenia: results of a phase 3, multicenter, double-blinded, placebo-controlled, randomized clinical trial (ADVANCE IV)","volume":"140","author":"Broome","year":"2022","journal-title":"Blood"},{"key":"B80","doi-asserted-by":"publisher","first-page":"7S","DOI":"10.1016\/s0041-1345(03)00211-2","article-title":"Sirolimus: its discovery, biological properties, and mechanism of action","volume":"35","author":"Sehgal","year":"2003","journal-title":"Transplant Proc"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2012.12.011","article-title":"Cytopenia and autoimmune diseases: a vicious cycle fueled by mTOR dysregulation in hematopoietic stem cells","volume":"41","author":"Zheng","year":"2013","journal-title":"J Autoimmun"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07595.x","article-title":"Treatment with sirolimus results in complete responses in patients with autoimmune lymphoproliferative syndrome","volume":"145","author":"Teachey","year":"2009","journal-title":"Br J Haematol"},{"key":"B83","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1111\/bjh.13533","article-title":"Mycofenolate mofetil and sirolimus as second or further line treatment in children with chronic refractory primary or secondary autoimmune cytopenias: a single center experience","volume":"171","author":"Miano","year":"2015","journal-title":"Br J Haematol"},{"key":"B84","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1182\/blood-2015-07-657981","article-title":"Sirolimus is effective in relapsed\/refractory autoimmune cytopenias: results of a prospective multi-institutional trial","volume":"127","author":"Bride","year":"2016","journal-title":"Blood"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V130.Suppl_1.4728.4728","article-title":"Sirolimus is effective in refractory immune thrombocytopenia: results of an open-label prospective multicenter trial in china","volume":"130","author":"Gao","year":"2017","journal-title":"Blood"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25119","article-title":"Sirolimus as a rescue therapy in children with immune thrombocytopenia refractory to mycophenolate mofetil","volume":"93","author":"Miano","year":"2018","journal-title":"Am J Hematol"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/548085","article-title":"Effects of rapamycin combined with low dose prednisone in patients with chronic immune thrombocytopenia","volume":"2013","author":"Li","year":"2013","journal-title":"Clin Dev Immunol"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.2147\/tcrm.2006.2.3.271","article-title":"Bortezomib (Velcadetrade mark) in the treatment of multiple myeloma","volume":"2","author":"Field-Smith","year":"2006","journal-title":"Ther Clin Risk Manag"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.2217\/imt.15.66","article-title":"Modulatory effects of bortezomib on host immune cell functions","volume":"7","author":"Pellom","year":"2015","journal-title":"Immunotherapy"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1669921","article-title":"Proteasome inhibition with bortezomib induces apoptosis of long-lived plasma cells in steroid-resistant or relapsed immune thrombocytopaenia","volume":"118","author":"Li","year":"2018","journal-title":"Thromb Haemost"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12696","article-title":"Bortezomib induces clinical remission and reduction of ADAMTS13 inhibitory antibodies in relapsed refractory idiopathic thrombotic thrombocytopenic purpura","volume":"164","author":"Mazepa","year":"2014","journal-title":"Br J Haematol"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1213206","article-title":"ADAMTS13 antibody depletion by bortezomib in thrombotic thrombocytopenic purpura","volume":"368","author":"Shortt","year":"2013","journal-title":"N Engl J Med"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1177\/20406207211046428","article-title":"Bortezomib in autoimmune hemolytic anemia and beyond","volume":"12","author":"Pasquale","year":"2021","journal-title":"Ther Adv Hematol"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14051035","article-title":"Development of new drugs for autoimmune hemolytic anemia","volume":"14","author":"Xiao","year":"2022","journal-title":"Pharmaceutics"},{"key":"B95","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000000517","article-title":"Bortezomib for refractory immune-mediated thrombocytopenia purpura","volume":"25","author":"Beckman","year":"2018","journal-title":"Am J Ther"},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.11406\/rinketsu.57.630","article-title":"Multiple myeloma developing in a patient with immune thrombocytopenia","volume":"57","author":"Itoh","year":"2016","journal-title":"Rinsho Ketsueki"},{"key":"B97","article-title":"Multiple myeloma developing during long-term clinical course of refractory immune thrombocytopenic purpura: a case report and review of literature","volume":"8","author":"Yao","year":"2015","journal-title":"Int J Clin Exp Pathol"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2021.2002835","article-title":"Refractory immune thrombocytopenia successfully treated with bortezomib in a child with 22q11.2 deletion syndrome, complicated by Evans syndrome and hypogammaglobulinemia","volume":"33","author":"Conti","year":"2022","journal-title":"Platelets"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003032","article-title":"Daratumumab, a novel therapeutic human CD38 monoclonal antibody, induces killing of multiple myeloma and other hematological tumors","volume":"186","author":"de Weers","year":"2011","journal-title":"J Immunol"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00946","article-title":"The changing landscape of autoimmune hemolytic anemia","volume":"11","author":"Barcellini","year":"2020","journal-title":"Front Immunol"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-020-04063-w","article-title":"Daratumumab for refractory warm autoimmune hemolytic anemia","volume":"100","author":"Jain","year":"2021","journal-title":"Ann Hematol"},{"key":"B102","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.649441","article-title":"The immunomodulatory effect and clinical efficacy of daratumumab in a patient with cold agglutinin disease","volume":"12","author":"Zaninoni","year":"2021","journal-title":"Front Immunol"},{"key":"B103","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2023325","article-title":"Targeting CD38 with daratumumab in refractory systemic lupus erythematosus","volume":"383","author":"Ostendorf","year":"2020","journal-title":"N Engl J Med"},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001215","article-title":"Successful treatment of thrombocytopenia with daratumumab after allogeneic transplant: a case report and literature review","volume":"4","author":"Migdady","year":"2020","journal-title":"Blood Adv"},{"key":"B105","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s40348-021-00114-y","article-title":"Daratumumab therapy for post-HSCT immune-mediated cytopenia: experiences from two pediatric cases and review of literature","volume":"8","author":"Driouk","year":"2021","journal-title":"Mol Cell Pediatr"},{"key":"B106","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16171","article-title":"Post-allogeneic transplant Evans syndrome successfully treated with daratumumab","volume":"187","author":"Blennerhassett","year":"2019","journal-title":"Br J Haematol"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17565","article-title":"Daratumumab for the management of autoimmune cytopenias in children and young adults: a case series","volume":"194","author":"Khandelwal","year":"2021","journal-title":"Br J Haematol"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279232","article-title":"Daratumumab, an original approach for treating multi-refractory autoimmune cytopenia","volume":"106","author":"Crickx","year":"2021","journal-title":"Haematologica"},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcmd.2023.102724","article-title":"Daratumumab as a novel treatment option in refractory ITP","volume":"99","author":"Vernava","year":"2023","journal-title":"Blood Cells Mol Dis"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-022-05035-y","article-title":"Long-term complete remission of refractory severe idiopathic immune thrombocytopenia (ITP) treated with daratumumab","volume":"102","author":"Strussmann","year":"2023","journal-title":"Ann Hematol"},{"key":"B111","doi-asserted-by":"publisher","DOI":"10.1097\/01.Hs9.0000852076.33574.89","article-title":"PB2313: DARATUMUMAB AS A TREATMENT FOR ADULT IMMUNE THROMBOCYTOPENIA: A PHASE II STUDY WITH SAFETY RUN-IN (THE DART STUDY)","volume":"6","author":"Tsykunova","year":"2022","journal-title":"HemaSphere"},{"key":"B112","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/kfj148","article-title":"Chronic administration of belimumab, a BLyS antagonist, decreases tissue and peripheral blood B-lymphocyte populations in cynomolgus monkeys: pharmacokinetic, pharmacodynamic, and toxicologic effects","volume":"91","author":"Halpern","year":"2006","journal-title":"Toxicol Sci"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.4103\/0976-500X.85930","article-title":"Belimumab: First targeted biological treatment for systemic lupus erythematosus","volume":"2","author":"Dubey","year":"2011","journal-title":"J Pharmacol Pharmacother"},{"key":"B114","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.259481","article-title":"Efficacy, safety and immunological profile of combining rituximab with belimumab for adults with persistent or chronic immune thrombocytopenia: results from a prospective phase 2b trial","volume":"106","author":"Mahevas","year":"2021","journal-title":"Haematologica"},{"key":"B115","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214720","article-title":"Treatment of primary Sjogren's syndrome with ianalumab (VAY736) targeting B cells by BAFF receptor blockade coupled with enhanced, antibody-dependent cellular cytotoxicity","volume":"78","author":"Dorner","year":"2019","journal-title":"Ann Rheum Dis"},{"key":"B116","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018025684","article-title":"Anti-BAFF-R antibody VAY-736 demonstrates promising preclinical activity in CLL and enhances effectiveness of ibrutinib","volume":"3","author":"McWilliams","year":"2019","journal-title":"Blood Adv"},{"key":"B117","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02251-0","article-title":"Safety and efficacy of subcutaneous ianalumab (VAY736) in patients with primary Sjogren's syndrome: a randomised, double-blind, placebo-controlled, phase 2b dose-finding trial","volume":"399","author":"Bowman","year":"2022","journal-title":"Lancet"},{"key":"B118","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01370-4","article-title":"Inebilizumab: first approval","volume":"80","author":"Frampton","year":"2020","journal-title":"Drugs"},{"key":"B119","doi-asserted-by":"publisher","DOI":"10.4161\/mabs.28841","article-title":"Suppression of innate and adaptive B cell activation pathways by antibody coengagement of FcgammaRIIb and CD19","volume":"6","author":"Szili","year":"2014","journal-title":"MAbs"},{"key":"B120","doi-asserted-by":"publisher","DOI":"10.1002\/art.38334","article-title":"Suppression of rheumatoid arthritis B cells by XmAb5871, an anti-CD19 antibody that coengages B cell antigen receptor complex and Fcgamma receptor IIb inhibitory receptor","volume":"66","author":"Chu","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"B121","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1805035","article-title":"Epigenetic therapies for cancer","volume":"383","author":"Bates","year":"2020","journal-title":"N Engl J Med"},{"key":"B122","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008477","article-title":"Low-dose decitabine modulates T-cell homeostasis and restores immune tolerance in immune thrombocytopenia","volume":"138","author":"Han","year":"2021","journal-title":"Blood"},{"key":"B123","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.630693","article-title":"Low-dose decitabine inhibits cytotoxic T lymphocytes-mediated platelet destruction via modulating PD-1 methylation in immune thrombocytopenia","volume":"12","author":"Han","year":"2021","journal-title":"Front Immunol"},{"key":"B124","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25646","article-title":"A prospective, multicenter study of low dose decitabine in adult patients with refractory immune thrombocytopenia","volume":"94","author":"Zhou","year":"2019","journal-title":"Am J Hematol"},{"key":"B125","doi-asserted-by":"publisher","DOI":"10.1191\/0961203305lu2109oa","article-title":"Mechanisms of action of mycophenolate mofetil","author":"Allison","year":"2005","journal-title":"Lupus"},{"key":"B126","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjbs.2019.09.013","article-title":"The clinical effect of Prednisone in combination with Mycophenolate mofetil on idiopathic thrombocytopenic purpura (ITP) and its influence on the level of peripheral blood T lymphocytes and NK lymphocytes","volume":"26","author":"Xu","year":"2019","journal-title":"Saudi J Biol Sci"},{"key":"B127","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1111\/j.1745-7254.2005.00088.x","article-title":"Mycophenolate mofetil as a treatment for refractory idiopathic thrombocytopenic purpura","volume":"26","author":"Zhang","year":"2005","journal-title":"Acta Pharmacol Sin"},{"key":"B128","doi-asserted-by":"publisher","DOI":"10.1179\/102453309X439782","article-title":"Should low-dose mycophenolate mofetil be used to prolong the response after rituximab therapy in patients with immune thrombocytopenic purpura? A case report","volume":"14","author":"Bruserud","year":"2009","journal-title":"Hematology"},{"key":"B129","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1002\/ajh.20515","article-title":"Efficacy of mycophenolate mofetil as single-agent therapy for refractory immune thrombocytopenic purpura","volume":"81","author":"Provan","year":"2006","journal-title":"Am J Hematol"},{"key":"B130","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03430.x","article-title":"Mycophenolate mofetil for the treatment of refractory auto-immune haemolytic anaemia and auto-immune thrombocytopenia purpura","volume":"117","author":"Howard","year":"2002","journal-title":"Br J Haematol"},{"key":"B131","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1182\/blood-2009-06-222448","article-title":"Combination immunosuppressant therapy for patients with chronic refractory immune thrombocytopenic purpura","volume":"115","author":"Arnold","year":"2010","journal-title":"Blood"},{"key":"B132","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0609.2003.00076.x","article-title":"Mycophenolate mofetil (MMF) for the treatment of steroid-resistant idiopathic thrombocytopenic purpura","volume":"70","author":"Hou","year":"2003","journal-title":"Eur J Haematol"},{"key":"B133","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2010.520372","article-title":"Mycophenolate mophetil therapy for chronic immune thrombocytopenic purpura resistant to steroids, immunosuppressants, and\/or splenectomy in adults","volume":"22","author":"Colovic","year":"2011","journal-title":"Platelets"},{"key":"B134","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2005.00437.x","article-title":"Efficacy of mycophenolate mofetil in adult refractory auto-immune cytopenias: a single center preliminary study","volume":"75","author":"Kotb","year":"2005","journal-title":"Eur J Haematol"},{"key":"B135","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13622","article-title":"Mycophenolate mofetil therapy for severe immune thrombocytopenia","volume":"171","author":"Taylor","year":"2015","journal-title":"Br J Haematol"},{"key":"B136","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2100596","article-title":"Mycophenolate mofetil for first-line treatment of immune thrombocytopenia","volume":"385","author":"Bradbury","year":"2021","journal-title":"N Engl J Med"},{"key":"B137","doi-asserted-by":"publisher","DOI":"10.1016\/s0162-3109(00)00192-2","article-title":"Mechanisms of action of cyclosporine","volume":"47","author":"Matsuda","year":"2000","journal-title":"Immunopharmacology"},{"key":"B138","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02893.x","article-title":"Cyclosporin A for the treatment of patients with chronic idiopathic thrombocytopenic purpura refractory to corticosteroids or splenectomy","volume":"114","author":"Kappers-Klunne","year":"2001","journal-title":"Br J Haematol"},{"key":"B139","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12741","article-title":"A possible role for low-dose cyclosporine in refractory immune thrombocytopenic purpura","volume":"93","author":"Emilia","year":"2008","journal-title":"Haematologica"},{"key":"B140","doi-asserted-by":"publisher","DOI":"10.1532\/IJH97.05149","article-title":"Cyclosporin A as an immunosuppressive treatment modality for patients with refractory autoimmune thrombocytopenic purpura after splenectomy failure","volume":"83","author":"Zver","year":"2006","journal-title":"Int J Hematol"},{"key":"B141","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.182","article-title":"Refractory immune thrombocytopenia. Successful treatment with repeated cyclosporine A: two case reports","volume":"3","author":"Hlusi","year":"2015","journal-title":"Clin Case Rep"},{"key":"B142","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-016-2791-y","article-title":"Cyclosporin A for persistent or chronic immune thrombocytopenia in children","volume":"95","author":"Liu","year":"2016","journal-title":"Ann Hematol"},{"key":"B143","doi-asserted-by":"publisher","DOI":"10.1177\/20406207221097780","article-title":"Efficacy and safety of cyclosporine A treatment in autoimmune cytopenias: the experience of two Italian reference centers","volume":"13","author":"Fattizzo","year":"2022","journal-title":"Ther Adv Hematol"},{"key":"B144","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-631937","article-title":"A novel triple therapy for ITP using high-dose dexamethasone, low-dose rituximab, and cyclosporine (TT4)","volume":"126","author":"Choi","year":"2015","journal-title":"Blood"},{"key":"B145","doi-asserted-by":"publisher","DOI":"10.1177\/03000605221149870","article-title":"Efficacy and safety of cyclosporine-based regimens for primary immune thrombocytopenia: a systematic review and meta-analysis","volume":"51","author":"Li","year":"2023","journal-title":"J Int Med Res"},{"key":"B146","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-022-02651-3","article-title":"Oseltamivir as rescue therapy for persistent, chronic, or refractory immune thrombocytopenia: a case series and review of the literature","volume":"54","author":"Colunga-Pedraza","year":"2022","journal-title":"J Thromb Thrombolysis"},{"key":"B147","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(21)00030-2","article-title":"Dexamethasone plus oseltamivir versus dexamethasone in treatment-naive primary immune thrombocytopenia: a multicentre, randomised, open-label, phase 2 trial","volume":"8","author":"Sun","year":"2021","journal-title":"Lancet Haematol"},{"key":"B148","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.212845","article-title":"Thrombopoietin receptor agonists: ten years later","volume":"104","author":"Ghanima","year":"2019","journal-title":"Haematologica"},{"key":"B149","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054626","article-title":"AMG 531, a thrombopoiesis-stimulating protein, for chronic ITP","volume":"355","author":"Bussel","year":"2006","journal-title":"N Engl J Med"},{"key":"B150","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S0140-6736(08)60203-2","article-title":"Efficacy of romiplostim in patients with chronic immune thrombocytopenic purpura: a double-blind randomised controlled trial","volume":"371","author":"Kuter","year":"2008","journal-title":"Lancet"},{"key":"B151","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/S0140-6736(10)60959-2","article-title":"Eltrombopag for management of chronic immune thrombocytopenia (RAISE): a 6-month, randomised, phase 3 study","volume":"377","author":"Cheng","year":"2011","journal-title":"Lancet"},{"key":"B152","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15573","article-title":"Phase 3 randomised study of avatrombopag, a novel thrombopoietin receptor agonist for the treatment of chronic immune thrombocytopenia","volume":"183","author":"Jurczak","year":"2018","journal-title":"Br J Haematol"},{"key":"B153","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60402-5","article-title":"Effect of eltrombopag on platelet counts and bleeding during treatment of chronic idiopathic thrombocytopenic purpura: a randomised, double-blind, placebo-controlled trial","volume":"373","author":"Bussel","year":"2009","journal-title":"Lancet"},{"key":"B154","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002625","article-title":"Romiplostim or standard of care in patients with immune thrombocytopenia","volume":"363","author":"Kuter","year":"2010","journal-title":"N Engl J Med"},{"key":"B155","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200931","article-title":"Eltrombopag and improved hematopoiesis in refractory aplastic anemia","volume":"367","author":"Olnes","year":"2012","journal-title":"N Engl J Med"},{"key":"B156","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-015-0525-4","article-title":"Lusutrombopag: first global approval","volume":"76","author":"Kim","year":"2016","journal-title":"Drugs"},{"key":"B157","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s13045-021-01047-9","article-title":"A multicenter, randomized phase III trial of hetrombopag: a novel thrombopoietin receptor agonist for the treatment of immune thrombocytopenia","volume":"14","author":"Mei","year":"2021","journal-title":"J Hematol Oncol"},{"key":"B158","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01553-7","article-title":"Thrombopoietin receptor agonists (TPO-RAs): drug class considerations for pharmacists","volume":"81","author":"Gilreath","year":"2021","journal-title":"Drugs"},{"key":"B159","doi-asserted-by":"publisher","DOI":"10.1177\/2040620719837906","article-title":"Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia","volume":"10","author":"Gonzalez-Porras","year":"2019","journal-title":"Ther Adv Hematol"},{"key":"B160","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18081","article-title":"Adults with immune thrombocytopenia who switched to avatrombopag following prior treatment with eltrombopag or romiplostim: A multicentre US study","volume":"197","author":"Al-Samkari","year":"2022","journal-title":"Br J Haematol"},{"key":"B161","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12888","article-title":"The temporary use of thrombopoietin-receptor agonists may induce a prolonged remission in adult chronic immune thrombocytopenia. Results of a French observational study","volume":"165","author":"Mahevas","year":"2014","journal-title":"Br J Haematol"},{"key":"B162","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-04-281717","article-title":"Improved regulatory T-cell activity in patients with chronic immune thrombocytopenia treated with thrombopoietic agents","volume":"116","author":"Bao","year":"2010","journal-title":"Blood"},{"key":"B163","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022018665","article-title":"Prolonged response after TPO-RA discontinuation in primary ITP: results of a prospective multicenter study","volume":"171","author":"Guillet","year":"2023","journal-title":"Blood"},{"key":"B164","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13648","article-title":"Classical complement pathway activation in immune thrombocytopenia purpura: inhibition by a novel C1s inhibitor","volume":"173","author":"Peerschke","year":"2016","journal-title":"Br J Haematol"},{"key":"B165","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021006864","article-title":"Safety and efficacy of classical complement pathway inhibition with sutimlimab in chronic immune thrombocytopenia","volume":"7","author":"Broome","year":"2023","journal-title":"Blood Adv"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1215216\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T13:42:22Z","timestamp":1690551742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1215216\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,28]]},"references-count":165,"alternative-id":["10.3389\/fimmu.2023.1215216"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1215216","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,28]]},"article-number":"1215216"}}