TPO and autoimmune thrombocytopenic purpura: Refractory ITP is a serious, life-threatening disease, but since the approval of TPO-RAs, it has been reported that more than 80% of patients who are refractory to both steroids and IVIg responded to romiplostim [20,21], indicating that romiplostim has been shown to be effective in the treatment of refractory ITP.