Thrombotic Thrombocytopenic Purpura
New thrombotic thrombocytopenic purpura research, summarized each month in plain language.
2026 so far: So far in 2026, real-world reports in immune TTP described how caplacizumab and rituximab are being used as add-ons and highlighted the push for faster ADAMTS13 testing. In congenital TTP, prevention evidence strengthened for recombinant ADAMTS13. Read the 2026 review
We also cover clinical trials.
Yearly update
2026 so far
- Caplacizumab add-on results. Benefits replicated in cohorts, while early flare and dosing issues emerged.
- Rituximab outcomes. More routine use reported, with relapse signals varying by cohort.
- Recombinant ADAMTS13 prevention. Evidence progressed from biomarker effects to phase 3 prevention outcomes.
- Plasma exchange burden. Complication reporting broadened from catheters to procedure hypotension risk.
- Faster ADAMTS13 testing. Shift toward rapid platforms, repeat testing, and workflow-aware interpretation.
New
September 2026
- Caplacizumab use. Plasma exchange days were fewer, but ADAMTS13 recovery sometimes lagged.
- Missed doses. Missed caplacizumab doses with very low ADAMTS13 were linked to worsening.
- Fast ADAMTS13 test. Rapid ADAMTS13 testing helped confirm or rule out TTP sooner.
- Hereditary prevention. Recombinant ADAMTS13 prevention was linked to fewer episodes and side effects.
August 2026
- Caplacizumab add-on. Linked to faster blood recovery and fewer plasma exchanges.
- Rituximab relapse risk. Relapses were lower, but results were not statistically clear.
- Faster ADAMTS13 testing. Portable tests may speed results, but need more validation.
- Relapse warning signal. An antibody test changed before relapse in some patients.
July 2026
- Add-on medicines. Caplacizumab and rituximab were linked to faster platelet recovery.
- Platelet transfusion risk. Early platelet transfusion was linked to higher 30-day death and heart attacks.
- Caplacizumab safety. Reports often described bleeding or injection-site and skin reactions.
- ADAMTS13 testing. ADAMTS13 testing helped separate immune TTP from similar conditions.
June 2026
- Hospital time. Caplacizumab use was linked to fewer exchanges and shorter stays.
- Early worsening. Short-term worsening was reported more often with caplacizumab.
- Low blood pressure. Low blood pressure occurred in 15.3% of plasmapheresis sessions.
May 2026
- Tweaked blood score. A revised blood-based score (swapping one lab value for LDH) modestly improved separation of immune TTP from similar conditions.
- Lower accuracy after 60. The same diagnostic score was less accurate in people age 60 and older.
- Earlier plasma exchange stop. In a small observational comparison, stopping plasma exchange earlier showed similar platelet recovery when caplacizumab and immunosuppression were used.
- Relapse-prevention follow-up. Surveyed survivors often reported limited discussion and monitoring focused on relapse prevention.
April 2026
- Hospital treatment patterns. In German inpatient data, rituximab and caplacizumab were used more often over time.
- Recombinant ADAMTS13 effects. In randomized trials, recombinant ADAMTS13 increased measured ADAMTS13 activity, but it did not clearly reduce acute TTP events.
- Symptoms over time in hereditary TTP. In a small registry study, people with hereditary TTP reported ongoing symptoms that changed little over 12 months.
- Conditions that can look like TTP. Some vitamin deficiencies and some cancer-related settings can cause TTP-like illness and complicate diagnosis.
March 2026
- Repeat ADAMTS13 testing. Repeating ADAMTS13 testing over time helped distinguish immune TTP from sepsis-related clotting problems.
- ADAMTS13 result timing. The time to get ADAMTS13 results varied by region and could delay diagnostic clarity.
- TTP in pregnancy. In pregnancy, TTP sometimes did not show classic symptoms, which made diagnosis harder.
- Caplacizumab add-on use. Caplacizumab was reported as an add-on to standard care, but only in a small number of cases.
February 2026
- Platelet recovery with caplacizumab. In immune TTP treated with caplacizumab, platelet counts often rose quickly, and slower recovery was frequently linked to other causes of low platelets.
- Bleeding after starting treatment. Bleeding was the most commonly reported event after caplacizumab, and many reports described bleeding early in the treatment course.
- Conditions that mimic TTP. Some TTP-like presentations only become clear with follow-up testing, such as malignant hypertension that initially resembled TTP or early antibody testing that was negative at first.
January 2026
- Platelet recovery speed. Caplacizumab in acute immune TTP was linked to faster platelets.
- Rituximab outcomes. Hospital cohorts linked rituximab use with better outcomes.
- Plasma exchange risks. One center reported frequent central-line complications during plasma exchange.
- Relapse risk factors. Relapse after remission was linked to symptoms and patient factors.
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