| | Advantages | Disadvantages |
| First-line therapy |
| Glucocorticoids | - Effective
- Oral administration
- Familiar
- Inexpensive
- Short-term toxicities usually tolerable
| - Durable response after discontinuation may be uncommon
- Serious long-term toxicities
|
| Rescue therapy |
| IVIG | | - Frequent side effects
- Cost
|
| Second-line and subsequent therapies |
| Splenectomy | - Efficacy
- Long duration of response
- Does not require ongoing therapy
| - Surgical risks
- Infectious risks from asplenia
- Thrombosis risk
|
| Rituximab | - Familiar
- Non-surgical
- Does not require ongoing therapy
| - Less effective than splenectomy
- Shorter remissions
- Risks of viral reactivation (especially hepatitis B)
- Risks of other toxicities (anaphylaxis, pulmonary toxicity)
|
| Thrombopoietin receptor agonist (TPO-RA) | - Efficacy
- Potential for self-administration
- Non-surgical
- No immunosuppression
| - Requires continuous administration
- Cost
|
| Fotamatinib | | - Requires continuous administration
- Gastrointestinal toxicity and hypertension
- Cost
|
| Other immunosuppressive agents or combination therapy | - May be effective when other therapies fail to establish a safe platelet count
| - High risk of immunosuppression and other side effects
|
