Appropriate Management of Thrombotic Risk in Patients With Primary Immune Thrombocytopenia in the UK: A Modified Delphi Consensus

Introduction:
Immune thrombocytopenia (ITP) is characterised by a low platelet count and increased risk of bleeding. Recent research has also proposed that having ITP increases thrombosis risk. Moreover, certain ITP treatments have been associated with an increased risk of thrombosis. This Delphi study aims to assess haematologist opinion regarding aspects of optimise thrombotic risk management in primary ITP in the UK.

Methods:
The methodology employed a modified Delphi process with two rounds of evaluation from a panel of experts. A literature review on the topic of primary ITP generated input to a steering group of three experts from the UK attended a virtual meeting in May 2024. During this meeting, and guided by an independent facilitator, the group identified five main domains. From these, 42 statements were agreed and developed into an online survey for testing with a wider panel of peers.

Results:
Overall, 33 statements achieved consensus agreement, and one statement did not achieve consensus. Eight scenario statements were included to identify preferable treatment options among healthcare professionals.

Conclusion:
Based on the agreement levels achieved, the steering group formulated a set of recommendations to optimise the management of thrombotic risk in patients with primary ITP in the UK.

Trial Registration:
The authors have confirmed clinical trial registration is not needed for this submission.