A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience

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 (/mm(3)) and defined as complete (platelet count of >100,000/mm(3)), partial (30,000-100,000/mm(3) or doubling of platelet count after treatment), or unresponsive (<30,000/mm(3)). 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.

Yazar Cekdemir, Demet
Guvenc, Serkan
Ozdemirkiran, Fusun
Eser, Ali
Topts, Tayfur
Ozkocaman, Vildan
Sahin, Handan Haydaroglu
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/1959
Tek Biçim Adres 10.4274/tjh.galenos.2019.2018.0307
Konu Başlıkları Thrombocytopenia
Immune thrombocytopenic
Eltrombopag
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS 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
Yazar
[dc.contributor.author]
Cekdemir, Demet
Yazar
[dc.contributor.author]
Guvenc, Serkan
Yazar
[dc.contributor.author]
Ozdemirkiran, Fusun
Yazar
[dc.contributor.author]
Eser, Ali
Yazar
[dc.contributor.author]
Topts, Tayfur
Yazar
[dc.contributor.author]
Ozkocaman, Vildan
Yazar
[dc.contributor.author]
Sahin, Handan Haydaroglu
Yayın Yılı
[dc.date.issued]
2019
Yayıncı
[dc.publisher]
GALENOS YAYINCILIK
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 (/mm(3)) and defined as complete (platelet count of >100,000/mm(3)), partial (30,000-100,000/mm(3) or doubling of platelet count after treatment), or unresponsive (<30,000/mm(3)). 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.
Açıklama
[dc.description]
WOS: 000497303100003
Açıklama
[dc.description]
PubMed: 31327186
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]
Thrombocytopenia
Konu Başlıkları
[dc.subject]
Immune thrombocytopenic
Konu Başlıkları
[dc.subject]
Eltrombopag
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
1300-7777
ISSN
[dc.identifier.issn]
1308-5263
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/20.500.12628/1959
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
22
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
09 Şubat 2024 09:57
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treatment patients response eltrombopag effects platelet partial chronic (range 000/mm(3)) complete Results maximum variable follow-up significantly descriptive increased overall (n=68) (1-202 levels (n=61) reduced (n=12) (n=10) Considering thrombocyte before required Objective weeks) elderly However closely
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