A phase 2 trial combining ianalumab, a monoclonal antibody targeting CD20-positive B cells, with eltrombopag, a thrombopoietin receptor agonist, demonstrated sustained platelet responses in adults with chronic immune thrombocytopenia (ITP). The dual-mechanism approach targets both the autoimmune destruction of platelets and stimulates new platelet production, offering a potentially transformative treatment paradigm for this challenging blood disorder. This combination strategy represents a significant advance in ITP management, addressing the condition's dual pathophysiology more comprehensively than single-agent therapies. For patients with chronic ITP who struggle with bleeding risks and steroid dependence, this approach could provide more durable remissions while potentially reducing long-term immunosuppression needs. The trial's success validates the rationale of simultaneously depleting pathogenic B cells while boosting platelet production. However, the combination's safety profile, optimal dosing sequences, and long-term efficacy across diverse patient populations require further investigation. If confirmed in larger studies, this dual-targeted strategy could establish a new standard of care for refractory ITP, moving beyond symptom management toward sustained disease modification.