How do you approach an ITP patient who responds very well to steroids but the response is short-lived?

Introduce second line therapy. Rituxan pr TPO-RA.

Rituximab is probably no longer the treatment of choice for ITP secondary therapy for the majority of patients. Although it has a good initial response, the majority of patients relapse in the first 1 to 2 years leaving a choice of retreating and persistent immunosuppression or trying another therap...

All choices may apply, depending on the patient's tolerance and specific health issues.