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Efficacy and safety of repeated use of lusutrombopag prior to radiofrequency ablation in patients with recurrent hepatocellular carcinoma and thrombocytopenia
Author(s) -
Ishikawa Toru,
Okoshi Marina,
Tomiyoshi Kei,
Kojima Yuichi,
Horigome Ryoko,
Imai Michitaka,
Nozawa Yujiro,
Iwanaga Akito,
Sano Tomoe,
Honma Terasu,
Yoshida Toshiaki
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13305
Subject(s) - medicine , hepatocellular carcinoma , platelet , platelet transfusion , adverse effect , thrombosis , radiofrequency ablation , thrombopoietin , portal vein thrombosis , gastroenterology , rash , surgery , chronic liver disease , thrombocytosis , ablation , cirrhosis , stem cell , haematopoiesis , biology , genetics
Aims Thrombocytopenia is often associated with chronic liver disease. Lusutrombopag is a small molecule thrombopoietin receptor agonist designed to temporarily increase the platelet count in patients with chronic liver disease for whom elective invasive procedures are planned. In the present study, the efficacy and safety of repeated use of lusutrombopag prior to radiofrequency ablation (RFA) for recurrent hepatocellular carcinoma were examined. Methods Eight patients with hepatocellular carcinoma who had a platelet count <50 000/μL prior to both initial and repeat RFA at the time of recurrence received lusutrombopag (3 mg/day) orally for 7 days between March 2016 and August 2018. The following were compared: the effect of lusutrombopag to increase the platelet count as determined by the platelet count after the initial and repeated use of lusutrombopag, the rate of avoiding platelet transfusion, and the presence of any complications. Results The platelet count increased to 103 100 ± 22 800/μL 14 days after the first treatment and to 110 700 ± 17 800/μL 14 days after the repeated use. None of the patients required platelet transfusion. None of the patients developed clinical symptoms such as thrombosis, fever, rash, portal vein thrombosis, bleeding, or any other serious adverse events. Conclusions Repeated use of lusutrombopag increased the platelet count. It did not cause any serious adverse events and led to avoidance of platelet transfusion. Radiofrequency ablation was carried out safely in all patients. Future studies with more cases of repeated use are needed to examine the long‐term efficacy and safety of lusutrombopag.