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Use of eltrombopag after romiplostim in primary immune thrombocytopenia
Author(s) -
GonzálezPorras José Ramón,
MingotCastellano María Eva,
Andrade Marcio M.,
Alonso Rafael,
Caparrós Isabel,
Arratibel María Carmen,
FernándezFuertes Fernando,
Cortti Maria José,
Pascual Cristina,
SánchezGonzález Blanca,
Bernat Silvia,
FuertesPalacio Miguel Angel,
VázquezPaganini Juan Andrés,
Olivera Pavel E.,
AlvarezRomán María Teresa,
Jarque Isidro,
Cortés Montserrat,
MartínezRobles Violeta,
DíazGálvez Francisco Javier,
Calbacho María,
FernándezMiñano Carmen,
GarciaFrade Javier,
GonzálezLópez Tomás José
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13266
Subject(s) - eltrombopag , romiplostim , discontinuation , medicine , adverse effect , interquartile range , immune thrombocytopenia , thrombopoietin , thrombopoietin receptor , cohort , platelet , genetics , stem cell , haematopoiesis , biology
Summary The thrombopoietin receptor agonists ( THPO ‐ RA s), romiplostim and eltrombopag, are effective and safe in immune thrombocytopenia ( ITP ). However, the value of their sequential use when no response is achieved or when adverse events occur with one THPO ‐ RA has not been clearly established. Here we retrospectively evaluated 51 primary ITP adult patients treated with romiplostim followed by eltrombopag. The median age of our cohort was 49 (range, 18–83) years. There were 32 women and 19 men. The median duration of romiplostim use before switching to eltrombopag was 12 (interquartile range 5–21) months. The reasons for switching were: lack of efficacy ( n = 25), patient preference ( n = 16), platelet‐count fluctuation ( n = 6) and side‐effects ( n = 4). The response rate to eltrombopag was 80% (41/51), including 67% ( n = 35) complete responses. After a median follow‐up of 14 months, 31 patients maintained their response. Efficacy was maintained after switching in all patients in the patient preference, platelet‐count fluctuation and side‐effect groups. 33% of patients experienced one or more adverse events during treatment with eltrombopag. We consider the use of eltrombopag after romiplostim for treating ITP to be effective and safe. Response to eltrombopag was related to the cause of romiplostim discontinuation.