ISTH TTP 2025 — 2025 Focused Update of the 2020 ISTH Guidelines for Management of Thrombotic Thrombocytopenic Purpura

For immune TTP, the 2025 focused update did not materially change the 2020 acute-event recommendations (urgent plasma exchange plus immunosuppression, with caplacizumab in appropriate patients). The update mainly addresses congenital TTP prophylaxis and ADAMTS13 replacement, favoring recombinant ADAMTS13 where available or prophylactic plasma over watch-and-wait in selected cTTP remission settings.