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In patients with secondary ITP, the Group's recommendations indicate that the lines of treatment must take into account the underlying disease. In the specific case of ITP associated with systemic lupus erythematosus, the recently published EULAR guidelines slightly modify the therapeutic algorithm, placing rituximab in the second step and TPO-RA in the third,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> recommending the use of belimumab in cases of mild thrombocytopenia, between 20 and 50 × 10<span class="elsevierStyleSup">9</span>/l. Dual blockade with rituximab associated with belimumab could be a promising combination for refractory cases.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">This paper has not received any type of funding.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Callejas Rubio JL, Ríos Fernandez R, García Martín P. Recomendaciones del Grupo Español de PTI para el diagnóstico, tratamiento y seguimiento de pacientes con trombocitopenia immune. Med Clin (Barc). 2022;158:e1.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines of the Spanish ITP Group for the diagnosis, treatment and follow-up of patients with immune thrombopenia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Lozano" 1 => "M.A. Sanz" 2 => "V. Vicente" 3 => "Grupo Español de PTI (GEPTI)" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2021.03.017" "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2021" "volumen" => "157" "paginaInicial" => "191" "paginaFinal" => "198" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of <span class="elsevierStyleItalic">Helicobacter pylori</span> eradication on patients with ITP: a meta-analysis of studies conducted in the Middle East" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.M.S. Pezeshki" 1 => "N. Saki" 2 => "M.V. Ghandali" 3 => "A. Ekrami" 4 => "A.Y. Avarvand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5045/br.2021.2020189" "Revista" => array:6 [ "tituloSerie" => "Blood Res" "fecha" => "2021" "volumen" => "56" "paginaInicial" => "38" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33707351" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Platelet Immunology Scientific, Standardization Committee. International survey on <span class="elsevierStyleItalic">Helicobacter pylori</span> testing in patients with immune thrombocytopenia: communication of the platelet immunology scientific and standardization committee" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Vishnu" 1 => "J. Duncan" 2 => "N. Connell" 3 => "N. Cooper" 4 => "W. Lim" 5 => "F.T. Rodeghiero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jth.15136" "Revista" => array:6 [ "tituloSerie" => "J Thromb Haemost" "fecha" => "2021" "volumen" => "19" "paginaInicial" => "287" "paginaFinal" => "296" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33070448" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on the diagnosis and management of systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Fanouriakis" 1 => "N. Tziolos" 2 => "G. Bertsias" 3 => "D.T. Boumpas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2020-218272" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2021" "volumen" => "80" "paginaInicial" => "14" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33051219" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "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" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Mahévas" 1 => "I. Azzaoui" 2 => "E. Crickx" 3 => "F. Canoui-Poitrine" 4 => "D. Gobert" 5 => "L. Languille" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.2020.259481" "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "2021" "volumen" => "106" "paginaInicial" => "2449" "paginaFinal" => "2457" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32817288" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000011/v1_202206190623/S2387020622002200/v1_202206190623/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000011/v1_202206190623/S2387020622002200/v1_202206190623/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002200?idApp=UINPBA00004N" ]
