Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study
ABSTRACT Background Oral thrombopoietin receptor agonists are used to treat thrombocytopenia in patients with chronic liver disease who are scheduled for invasive procedures. The efficacy of lusutrombopag based on the pretreatment platelet count was investigated. Methods Patients treated at nine hos...
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Wiley
2025-01-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70081 |
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| author | Takayoshi Suga Satoru Kakizaki Atsushi Naganuma Takeshi Hatanaka Satoshi Takakusagi Daichi Takizawa Hirotaka Arai Takashi Ueno Keisuke Iizuka Toru Fukuchi Shuichi Saito Hiroki Tojima Yuichi Yamazaki Toshio Uraoka |
| author_facet | Takayoshi Suga Satoru Kakizaki Atsushi Naganuma Takeshi Hatanaka Satoshi Takakusagi Daichi Takizawa Hirotaka Arai Takashi Ueno Keisuke Iizuka Toru Fukuchi Shuichi Saito Hiroki Tojima Yuichi Yamazaki Toshio Uraoka |
| author_sort | Takayoshi Suga |
| collection | DOAJ |
| description | ABSTRACT Background Oral thrombopoietin receptor agonists are used to treat thrombocytopenia in patients with chronic liver disease who are scheduled for invasive procedures. The efficacy of lusutrombopag based on the pretreatment platelet count was investigated. Methods Patients treated at nine hospitals from December 2015 to December 2023 were included. Efficacy was assessed by comparing the proportion of patients achieving a platelet count ≥ 50 000/μL and the change in platelet count. Results Seventy patients were eligible for evaluation. Patients with a pretreatment platelet count < 40 000/μL had a significantly lower rate of achieving a platelet count of ≥ 50 000/μL than those with a pretreatment count of 40 000–50 000/μL (62.5% vs. 84.2%, p = 0.038); however, there was no significant difference in the change in platelet count (25 700 vs. 24 400/μL, p = 0.972). Patients with viral‐related cirrhosis showed a significantly greater change in platelet count than the others (29 100 vs. 19 200/μL, p = 0.012). For patients receiving multiple lusutrombopag treatments, the change in platelet count was significantly lower in the second treatment than in the first treatment (26 900 vs. 20 800/μL, p = 0.041). The main adverse event observed was thrombosis (2.9%). Discussion Lusutrombopag increases platelet count regardless of pretreatment levels, but efficacy, defined as achieving a platelet count of ≥ 50 000/μL, may be insufficient in patients with a pretreatment platelet count < 40 000/μL. Additionally, patients with non‐viral liver disease responded less well to treatment compared to those with viral liver disease. Therefore, treatment strategies should be tailored based on pretreatment platelet counts and the etiology of liver disease. |
| format | Article |
| id | doaj-art-54f0c046faff465cba48fff7092a7913 |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-54f0c046faff465cba48fff7092a79132025-01-28T09:24:32ZengWileyJGH Open2397-90702025-01-0191n/an/a10.1002/jgh3.70081Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter StudyTakayoshi Suga0Satoru Kakizaki1Atsushi Naganuma2Takeshi Hatanaka3Satoshi Takakusagi4Daichi Takizawa5Hirotaka Arai6Takashi Ueno7Keisuke Iizuka8Toru Fukuchi9Shuichi Saito10Hiroki Tojima11Yuichi Yamazaki12Toshio Uraoka13Department of Gastroenterology NHO Shibukawa Medical Center Shibukawa JapanDepartment of Clinical Research NHO Takasaki General Medical Center Takasaki JapanDepartment of Gastroenterology NHO Takasaki General Medical Center Takasaki JapanDepartment of Gastroenterology Gunma Saiseikai Maebashi Hospital Takasaki JapanDepartment of Gastroenterology and Hepatology Kusunoki Hospital Takasaki JapanDepartment of Gastroenterology Maebashi Red Cross Hospital Takasaki JapanDepartment of Gastroenterology Maebashi Red Cross Hospital Takasaki JapanDepartment of Internal Medicine Isesaki Municipal Hospital Takasaki JapanDepartment of Internal Medicine Isesaki Municipal Hospital Takasaki JapanDepartment of Internal Medicine Kiryu Kosei General Hospital Takasaki JapanDepartment of Gastroenterology Public Tomioka General Hospital Takasaki JapanDepartment of Gastroenterology and Hepatology Gunma University Graduate School of Medicine Takasaki JapanDepartment of Gastroenterology and Hepatology Gunma University Graduate School of Medicine Takasaki JapanDepartment of Gastroenterology and Hepatology Gunma University Graduate School of Medicine Takasaki JapanABSTRACT Background Oral thrombopoietin receptor agonists are used to treat thrombocytopenia in patients with chronic liver disease who are scheduled for invasive procedures. The efficacy of lusutrombopag based on the pretreatment platelet count was investigated. Methods Patients treated at nine hospitals from December 2015 to December 2023 were included. Efficacy was assessed by comparing the proportion of patients achieving a platelet count ≥ 50 000/μL and the change in platelet count. Results Seventy patients were eligible for evaluation. Patients with a pretreatment platelet count < 40 000/μL had a significantly lower rate of achieving a platelet count of ≥ 50 000/μL than those with a pretreatment count of 40 000–50 000/μL (62.5% vs. 84.2%, p = 0.038); however, there was no significant difference in the change in platelet count (25 700 vs. 24 400/μL, p = 0.972). Patients with viral‐related cirrhosis showed a significantly greater change in platelet count than the others (29 100 vs. 19 200/μL, p = 0.012). For patients receiving multiple lusutrombopag treatments, the change in platelet count was significantly lower in the second treatment than in the first treatment (26 900 vs. 20 800/μL, p = 0.041). The main adverse event observed was thrombosis (2.9%). Discussion Lusutrombopag increases platelet count regardless of pretreatment levels, but efficacy, defined as achieving a platelet count of ≥ 50 000/μL, may be insufficient in patients with a pretreatment platelet count < 40 000/μL. Additionally, patients with non‐viral liver disease responded less well to treatment compared to those with viral liver disease. Therefore, treatment strategies should be tailored based on pretreatment platelet counts and the etiology of liver disease.https://doi.org/10.1002/jgh3.70081chronic liver diseaselusutrombopagthrombocytopenia |
| spellingShingle | Takayoshi Suga Satoru Kakizaki Atsushi Naganuma Takeshi Hatanaka Satoshi Takakusagi Daichi Takizawa Hirotaka Arai Takashi Ueno Keisuke Iizuka Toru Fukuchi Shuichi Saito Hiroki Tojima Yuichi Yamazaki Toshio Uraoka Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study JGH Open chronic liver disease lusutrombopag thrombocytopenia |
| title | Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study |
| title_full | Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study |
| title_fullStr | Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study |
| title_full_unstemmed | Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study |
| title_short | Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre‐Treatment Platelet Counts: A Retrospective Multicenter Study |
| title_sort | evaluation of the efficacy of lusutrombopag for chronic liver disease based on pre treatment platelet counts a retrospective multicenter study |
| topic | chronic liver disease lusutrombopag thrombocytopenia |
| url | https://doi.org/10.1002/jgh3.70081 |
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