Comparison of the efficacy and complication of Romiplostim and Rituximab in children with Chorionic Immune Thrombocytopenic Purpura

Introduction: Idiopathic thrombocytopenic purpura (ITP) is a chronic autoimmune disease that manifests as persistent thrombocytopenia and mucocutaneous bleeding. The aim of this study was to evaluate the effects and side effects of two drugs, Rituximab and Romiplostim, in children with ITP. Materials and methods: This prospective cohort study included children with ITP who were prescribed Romiplostim and Rituximab. The study followed the children for six months to monitor the medication's effectiveness and side effects, with the treatment response defined as an increase in platelet count to over 30,000 per cubic millimeter of blood. The patients were evaluated monthly for possible side effects such as fever, rash, respiratory infections, and peripheral edema. The data obtained from the patients were then analyzed using SPSS version 26 software. Results: In the current study, 140 children were included, with 70 children in each of the Rituximab and Romiplostim groups. The average age of the children participating in the study was between 8-9 years. There was no significant difference between the two study groups in terms of age. Changes in the average platelet count during 9 measurements were significantly higher in the Romiplostim group compared to Rituximab (P<0.001). Additionally, the treatment response rate was significantly higher in the Romiplostim group than in the Rituximab group (71.4% vs. 48.6% and P=0.006). In the present study, none of the children taking either drug experienced peripheral edema. When examining other side effects related to the use of these two drugs, it should be mentioned that the rates of fever, skin rashes, and respiratory infections, although not significantly different between the two study groups during the nine repeated measurements (P>0.05), were generally lower in the Romiplostim group than in the Rituximab group during the second to fourth weeks of the study. Conclusions: Romiplostim demonstrates superior efficacy compared to rituximab in raising peripheral blood platelet counts in pediatric patients with immune thrombocytopenia purpura. Furthermore, the treatment response rate is higher with Romiplostim and it is also associated with fewer complications when compared to rituximab.