A multi-center study on the efficacy of eltrombopag in management of refractory chronic immune thrombocytopenia: A real-life experience [Refrakter kronik immün trombositopeni tedavisinde eltrombopagın etkinliğine ilişkin çok merkezli bir çalışma: Gerçek yaşam deneyimi]

Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors. ©Copyright 2019 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.

Yazar Çekdemir D.
Güvenç S.
Özdemirkıran F.
Eser A.
Toptaş T.
Özkocaman V.
Şahin H.H.
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/3960
Tek Biçim Adres 10.4274/tjh.galenos.2019.2018.0307
Konu Başlıkları Eltrombopag
Immune thrombocytopenic
Thrombocytopenia
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
Scopus İndeksli Yayınlar Koleksiyonu
Dergi Adı Turkish Journal of Hematology
Dergi Cilt Bilgisi 36
Dergi Sayısı 4
Sayfalar 230 - 237
Yayın Yılı 2019
Eser Adı
[dc.title]
A multi-center study on the efficacy of eltrombopag in management of refractory chronic immune thrombocytopenia: A real-life experience [Refrakter kronik immün trombositopeni tedavisinde eltrombopagın etkinliğine ilişkin çok merkezli bir çalışma: Gerçek yaşam deneyimi]
Yazar
[dc.contributor.author]
Çekdemir D.
Yazar
[dc.contributor.author]
Güvenç S.
Yazar
[dc.contributor.author]
Özdemirkıran F.
Yazar
[dc.contributor.author]
Eser A.
Yazar
[dc.contributor.author]
Toptaş T.
Yazar
[dc.contributor.author]
Özkocaman V.
Yazar
[dc.contributor.author]
Şahin H.H.
Yayın Yılı
[dc.date.issued]
2019
Yayıncı
[dc.publisher]
Turkish Society of Hematology
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6%; 98 men, 34.4%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm3) and defined as complete (platelet count of >100,000/mm3), partial (30,000-100,000/mm3 or doubling of platelet count after treatment), or unresponsive (<30,000/mm3). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9±20.6 (range: 3-95) years and the duration of follow-up was 18.0±6.4 (range: 6-28.2) months. Overall response rate was 86.7% (n=247). Complete and partial responses were observed in 182 (63.8%) and 65 (22.8%) patients, respectively. Thirty-eight patients (13.4%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7% (n=61), and for those above 80 years old (n=12), overall response rate was 83% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6%), weakness (13.7%), hepatotoxicity (11.8%), and thrombosis (5.9%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors. ©Copyright 2019 by Turkish Society of Hematology Turkish Journal of Hematology, Published by Galenos Publishing House.
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
Eltrombopag
Konu Başlıkları
[dc.subject]
Immune thrombocytopenic
Konu Başlıkları
[dc.subject]
Thrombocytopenia
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
1300-7777
İlk Sayfa Sayısı
[dc.identifier.startpage]
230
Son Sayfa Sayısı
[dc.identifier.endpage]
237
Dergi Adı
[dc.relation.journal]
Turkish Journal of Hematology
Dergi Sayısı
[dc.identifier.issue]
4
Dergi Cilt Bilgisi
[dc.identifier.volume]
36
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.4274/tjh.galenos.2019.2018.0307
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/3960
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
117
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
15 Temmuz 2024 21:47
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treatment response patients eltrombopag effects platelet chronic partial overall 000/mm3) (range complete maximum Results follow-up descriptive variable increased Turkish Hematology significantly higher likely Notably weeks) (1-202 (n=61) (n=12) required reduced before thrombocyte Considering (n=10) levels
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