Background Idiopathic thrombocytopenic purpura (ITP) is a disease characterised by decreased platelet count. Romiplostim and eltrombopag are thrombopoietin receptor agonists (TRAs) that stimulate platelet production.
Purpose To evaluate the effectiveness and safety of TRAs in patients with ITP in a university hospital.
Material and methods Retrospective observational study including patients with ITP who were treated with TRAs.
The information collected was: age, gender, previous treatments, length of treatment, response to treatment and side effects.
Results From October 2009 to July 2014, fourteen patients with ITP [10 women (71.4%) and 4 men (28.6%) with an average age of 48.0 ± 16.7 years] were treated with TRAs.
Patients were classified according to treatment received: 7 patients with eltrombopag (50.0%), 2 patients with romiplostim (14.3%), and 5 patients with both drugs in succession (35.7%).
Four patients (28.6%) had received one previous treatment line, nine patients (64.3%) two previous lines and one patient (7.1%) had received three.
Only one patient had been splenectomised before the treatment.
The average treatment duration was 6.6 ± 5.3 months in the romiplostim group and 7.1 ± 5.9 months in the eltrombopag group.
The responses to eltrombopag were: 4 complete responses (57.1%) and 3 responses (42.9%); and to romiplostim: 1 complete response (50.0%) and 1 response (50.0%); in the group with both drugs: 3 complete responses (60.0%), 1 no response (20.0%) and 1 complete remission sustained and prolonged after having stopped the treatment (20.0%).
No side effects were observed, with the exception of one deep venous thrombosis (DVT) with eltrombopag.
Conclusion Our results, as well as previous studies, show that patients with ITP, despite having received multiple lines of treatment, respond well to TRAs, including complete remissions and sustained remissions after having stopped the treatment.
Tolerance of TRAs is good although DVT may appear.
References and/or Acknowledgements
Kuter DJ, et al. Romiplostim or standard of care in patients with ITP. N Engl J Med 2010;363:1889–99
Cheng G, et al. Eltrombopag for management of chronic ITP (RAISE): a 6-month, randomised, phase 3 study. Lancet 2011;377:393–402
References and/or AcknowledgementsNo conflict of interest.
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