5 years ago

Use of eltrombopag for secondary immune thrombocytopenia in clinical practice

Blanca Sánchez-González, Fernando Fernández-Fuentes, Elsa Lopez-Ansoar, José M. Bastida, María T. Alvarez-Román, Esther Arrieta-Cerdán, José A. Hernández-Rivas, Gloria Pérez-Rus, Tomás J. González-López, Marta Gómez-Nuñez, Estefanía Bolaños, Laura Entrena, Violeta Martínez-Robles, María P. Martínez-Badas, María Tenorio, María Yera Cobo, Rafael Alonso, José R. González-Porras, Inmaculada Soto, Arancha Alonso, Pavel Olivera, Silvia Bernat, Javier García-Frade, Cristina Pascual, Isabel Caparrós
Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated. Forty-four patients (38%) had a platelet response, including 40 (35%) with complete responses. Median time to platelet response was 15 days (95% confidence interval, 7–28 days), and was longer in the LPD-ITP group. Platelet response rate was significantly lower in the LPD-ITP than in other groups. However, having achieved response, there were no significant differences between the durable response of the groups. Forty-three patients (49·4%) experienced adverse events (mainly grade 1–2), the commonest being hepatobiliary laboratory abnormalities. There were 10 deaths in this case series, all of which were related to pre-existing medical conditions. In routine clinical practice, eltrombopag is effective and well-tolerated in unselected patients with ITP secondary to both immune and infectious disorders. However, the response rate in LPD-ITP is low.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/bjh.14788

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