In patients with immune thrombocytopenia who do not adequately respond to 
first-line therapy, there is no clear consensus on which second-line therapy to 
initiate and when. This situation leads to suboptimal approaches, including 
prolonged exposure to treatments that are not intended for long-term use (eg, 
corticosteroids) and overuse of off-label therapies (eg, rituximab) while 
approved, more efficacious options exist. These approaches may not only fail to 
address symptoms and burden of disease, but may also worsen health-related 
quality of life. A better understanding of available second-line treatments may 
ensure best use of therapeutic options and thereby optimize patient outcomes.