Name of the Procedure:

Injection, romiplostim, 10 micrograms (HCPCS Code: J2796)

• Common Name: Romiplostim Injection
• Medical Terms: Thrombopoietin receptor agonist injection

Summary

The romiplostim injection is a medical procedure where a synthetic protein is administered to stimulate the production of platelets in the blood. It is typically used to treat patients with low platelet counts due to chronic immune thrombocytopenia (ITP).

Purpose

• Addressed Conditions: Chronic immune thrombocytopenia
• Goals: To increase and maintain platelet count, reduce the risk of bleeding, and decrease the need for other platelet count treatments.

Indications

• Symptoms/Conditions: Low platelet counts, frequent bruising or bleeding
• Patient Criteria: Individuals diagnosed with chronic ITP who have not responded adequately to other treatments

Preparation

• Pre-procedure Instructions: No special preparation is usually required. Patients may be advised to inform their doctor about all medications they are taking.
• Diagnostic Tests: Blood tests to measure platelet count and assess overall health.

Procedure Description

1. Initial Assessment: Patient evaluation and confirmation of current platelet count.
2. Injection: Romiplostim is administered subcutaneously (under the skin) using a fine needle, typically in the arm, abdomen, or thigh.
3. Tools/Equipment: Syringe and needle, antiseptic wipes.
4. Anesthesia/Sedation: Generally not required.

Duration

The injection itself takes a few minutes, though the total appointment may last about 30 minutes including preparation and observation time.

Setting

• Usually performed in an outpatient clinic, doctor’s office, or hospital outpatient department.

Personnel

• Administered by a healthcare professional such as a nurse or a doctor.

Risks and Complications

• Common Risks: Redness, swelling, or irritation at the injection site.
• Rare Risks: Allergic reactions, headaches, dizziness, increased risk of blood clots.
• Management: Monitoring and supportive care as needed.

Benefits

• Expected Benefits: Increased platelet counts and reduced risk of bleeding.
• Timeline for Benefits: Varies; some patients may see improvement in a few weeks, others a bit longer.

Recovery

• Post-procedure Care: No significant recovery period. Patients may resume normal activities immediately.
• Expected Recovery Time: Immediate, but monitoring of platelet counts will continue periodically.
• Restrictions/Follow-up: Regular follow-up appointments to monitor platelet levels and adjust dosage as necessary.

Alternatives

• Other Treatment Options: Corticosteroids, immune globulin, splenectomy.
• Pros and Cons:
  • Corticosteroids: Fast-acting but with potential significant side effects like weight gain and hypertension.
  • Immune Globulin: Effective short-term solution but requires frequent administration.
  • Splenectomy: Permanent solution for some but involves surgery with inherent risks.

Patient Experience

• During the Procedure: Minimal discomfort typically associated with a subcutaneous injection.
• Post-procedure: Possible mild soreness at the injection site. Pain management usually involves over-the-counter pain relievers if needed. Most patients tolerate the procedure well and experience minimal discomfort.

Note: Individual responses to treatment can vary, and it's important for patients to discuss the specific details and any concerns with their healthcare provider.