TPO-RA in Primary Immune Thrombocytopenia (ITP) in Patients Older Than 14 Years

This study is for people with immune thrombocytopenia (ITP), a condition where the immune system attacks platelets — the cells that help blood clot. Specifically, it's for people whose ITP has not responded to standard first-line treatments or to certain platelet-boosting medications. The study is testing different thrombopoietin receptor agonist (TPO-RA) drugs — medications that stimulate the body to produce more platelets. You may be eligible if: • You are 14 years of age or older • You have been diagnosed with primary ITP with very low platelet counts (below 30×10⁹/L) or have bleeding symptoms • You have already tried first-line treatment and one or more standard platelet-boosting drugs without adequate response You may NOT be eligible if: • You have secondary ITP (caused by another disease) • You have a history of blood clots, heart attack, stroke, or certain autoimmune diseases • You have significant liver or kidney disease • You are allergic to the study drugs • You have had rituximab treatment or a splenectomy in the past 3 months • You are pregnant or planning to become pregnant soon Talk to your doctor to see if this trial is right for you.