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The use of thrombopoietin-receptor agonists (TPO-RAs) in immune thrombocytopenia (ITP): a "real life" retrospective multicenter experience of the Rete Ematologica Pugliese (REP).
- Source :
-
Annals of hematology [Ann Hematol] 2016 Jan; Vol. 95 (2), pp. 239-44. Date of Electronic Publication: 2015 Nov 24. - Publication Year :
- 2016
-
Abstract
- Immune thrombocytopenia (ITP) is a disease which sees one-third of patients failing first and subsequent therapeutic approaches, including splenectomy. Thrombopoietin-receptor agonists (TPO-RAs) are recommended for adults who relapse after splenectomy or who have contraindications for splenectomy. In this multicenter study, a total of 124 patients were retrospectively evaluated: 55 (44.3 %) were treated by romiplostim and 69 (55.6 %) by eltrombopag. Mean age, number of young patients (<60 years), time from primary diagnosis of ITP to TPO-RA treatment, and previous lines of therapy were similar in both groups. The overall response rate was 80 % (44/55) for romiplostim and 94.2 % (65/69) for eltrombopag; the duration of response and the time to response were similar (p = NS). The response rate to both drugs in non-splenectomized patients was higher than that of splenectomized patients (p < 0.05). The mean duration of response was 30 months for romiplostim and 15 months for eltrombopag, due to later commercialization of eltrombopag. Failure was the most frequent cause of discontinuation. Thrombotic events were the most consistent adverse events and were recorded in 2 and 3 % of patients treated by romiplostim and eltrombopag, respectively. In conclusion, romiplostim and eltrombopag are effective in the majority of patients with chronic ITP who failed several lines of therapy; whether TPO-RAs could substitute splenectomy is under discussion and studies are warranted.
- Subjects :
- Aged
Benzoates pharmacology
Cohort Studies
Female
Humans
Hydrazines pharmacology
Italy epidemiology
Male
Middle Aged
Purpura, Thrombocytopenic, Idiopathic diagnosis
Pyrazoles pharmacology
Recombinant Fusion Proteins pharmacology
Retrospective Studies
Thrombopoietin pharmacology
Benzoates therapeutic use
Hospitals trends
Hydrazines therapeutic use
Purpura, Thrombocytopenic, Idiopathic drug therapy
Purpura, Thrombocytopenic, Idiopathic epidemiology
Pyrazoles therapeutic use
Receptors, Fc therapeutic use
Receptors, Thrombopoietin agonists
Recombinant Fusion Proteins therapeutic use
Thrombopoietin therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 95
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 26596973
- Full Text :
- https://doi.org/10.1007/s00277-015-2556-z