Similarly, a study conducted in Spain that included patients diagnosed with ITP between 2011 and 2012 showed that more than one-third of patients who were re-treated due to failure or loss of response to prior steroid therapy were re-exposed to corticosteroids for two additional cycles.37Similar to current findings, the previous study also showed that TPO-RA were used immediately after failure of first-line therapy in only 25% of patients.37 This evidence concerns the gene TPO and autoimmune thrombocytopenic purpura.