Management of Thrombotic Thrombocytopenic Purpura (TTP) Without Plasma Exchange: An Update on the Austrian Experience

Paul Knoebl, M.D.
Medical University of Vienna
Vienna, Austria

Therapeutic plasma exchange (TPE) has long been considered as most important for thrombotic thrombocytopenic purpura (TTP). Recent treatment successes have been reported only with caplacizumab and immunosuppression but without TPE. Through this presentation Paul Knoebl, M.D. portrays the modified TTP management strategy that aims at avoiding TPE if platelet counts increase after a first dose of 10 mg caplacizumab, early addition of immunosuppression with steroids and rituximab, and continuing daily caplacizumab until ADAMTS13 increased >20%. This presentation also discusses that management of TTP is possible without an absolute need for TPE, thus indicating the need for a clinical trial to clarify TPE’s need in the era of caplacizumab.