In ITP, Fatigue May Be Underrecognized

Although patients with immune thrombocytopenia (ITP) often experience severe fatigue, this symptom may be underrecognized by physicians treating the condition, according to new research presented at the American Society of Hematology Annual Meeting.

These findings emerged from the ITP World Impact Survey, which included 1491 respondents with ITP from 12 countries and 472 physicians from 13 countries.

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Ultimately, Findings revealed that only 31% and 30% of physicians reported fatigue among their patients overall and at diagnosis, respectively, despite that patients often rated fatigue as one of their most severe symptoms at diagnosis and survey completion (74% and 65%, respectively).

Approximately 59% of physicians felt that fatigue was a very impactful symptom, while 66% of physicians believed that ITP-related fatigue was associated with reduced quality-of-life, and 46% felt that fatigue is often severe.

Physicians most frequently reported petechiae, purpura, bleeding of the gums, and epistaxis, both at diagnosis and overall. In addition, many physicians believed that blood in urine/stool (81%), profuse bleeding during surgery (79%), and menorrhagia (78%) had the largest impact on patients’ quality-of-life.

Among patients, petechiae, bruising, fatigue, and anxiety regarding a stable platelet could were among the most commonly reported signs and symptoms at diagnosis and survey completion. Other severe patient-reported symptoms included heavy menstrual bleeding and thrombosis.

“These results indicate that patients and MDs align on overall symptom burden in ITP but highlight that improved understanding and awareness of the relationships between fatigue, platelet count, and QoL is needed,” the authors of the study wrote.

Encouragingly, though, ITP patients generally reported satisfaction with their physicians’ management of their condition (79%), as well as communication and understanding of treatment goals.

—Christina Vogt

Reference:

Kruse C, Kruse A, Watson S, et al. Patients with immune thrombocytopenia (ITP) frequently experience severe fatigue but it is under-recognized by physicians: results from the ITP World Impact Survey (I-WISh). Paper presented at: 60th American Society of Hematology Annual Meeting & Exposition; December 1-4, 2018; San Diego, CA.