Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia
Background. Immune thrombocytopenia (ITP), or idiopathic thrombocytopenic purpura, is a hematological autoimmune disease characterized by bleeding and an isolated decrease in platelet count <100 × 109 / l. The decision to start treatment for ITP depends on several factors. The ITP treatment s...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
ABV-press
2023-09-01
|
| Series: | Онкогематология |
| Subjects: | |
| Online Access: | https://oncohematology.abvpress.ru/ongm/article/view/837 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849689899692720128 |
|---|---|
| author | S. G. Zakharov T. A. Mitina R. V. Vardanyan Z. R. Tekeeva I. N. Kontievskiy Yu. Yu. Chuksina A. V. Zakharova |
| author_facet | S. G. Zakharov T. A. Mitina R. V. Vardanyan Z. R. Tekeeva I. N. Kontievskiy Yu. Yu. Chuksina A. V. Zakharova |
| author_sort | S. G. Zakharov |
| collection | DOAJ |
| description | Background. Immune thrombocytopenia (ITP), or idiopathic thrombocytopenic purpura, is a hematological autoimmune disease characterized by bleeding and an isolated decrease in platelet count <100 × 109 / l. The decision to start treatment for ITP depends on several factors. The ITP treatment strategy is based on the clinical symptoms, with a focus on reducing the risk of severe bleeding and increasing platelet counts. Aim. To evaluate the efficacy of 2nd line therapy with the thrombopoietin receptor agonist eltrombopag in patients with ITP. Materials and methods. 490 patients with ITP are under observation at the center for orphan diseases of M. F. Vladimirskiy Moscow Regional Research Clinical Institute. The present study included 186 patients with primary ITP after 1st line glucocorticosteroid therapy. eltrombopag, a thrombopoietin receptor agonist, was prescribed as the 2nd line of therapy. Results. The median platelet count prior to eltrombopag therapy in all patients was 27.5 × 109 / l. after eltrombopag therapy, a significant (by 490 %) increase in platelet levels (median 135 × 109 / l) and a complete response according to clinical recommendations were noted. Conclusion. Glucocorticosteroids (prednisolone, dexamethasone) remain the drugs of choice for the 1st line of therapy. Treatment with drugs of this group in most cases allows achieving an optimal platelet level and preventing bleeding. In case of inefficiency, intolerance, occurrence of side effects, the appointment of thrombopoietin receptor agonists eltrombopag or romiplostim is recommended. therapy with eltrombopag at a dose of 50 mg daily for several weeks has been able to achieve an increase in platelet levels, correct hemorrhagic syndrome, reduce the number of side effects during first-line glucocorticosteroid therapy, and improve the patient’s quality of life. |
| format | Article |
| id | doaj-art-6fd1a167eedb4e1888c843365ac9a3da |
| institution | DOAJ |
| issn | 1818-8346 2413-4023 |
| language | Russian |
| publishDate | 2023-09-01 |
| publisher | ABV-press |
| record_format | Article |
| series | Онкогематология |
| spelling | doaj-art-6fd1a167eedb4e1888c843365ac9a3da2025-08-20T03:21:28ZrusABV-pressОнкогематология1818-83462413-40232023-09-01183656910.17650/1818-8346-2023-18-3-65-69698Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopeniaS. G. Zakharov0T. A. Mitina1R. V. Vardanyan2Z. R. Tekeeva3I. N. Kontievskiy4Yu. Yu. Chuksina5A. V. Zakharova6M. F. Vladimirskiy Moscow Regional Research Clinical InstituteM. F. Vladimirskiy Moscow Regional Research Clinical InstituteM. F. Vladimirskiy Moscow Regional Research Clinical InstituteM. F. Vladimirskiy Moscow Regional Research Clinical InstituteM. F. Vladimirskiy Moscow Regional Research Clinical InstituteM. F. Vladimirskiy Moscow Regional Research Clinical InstituteUnited Hospital with Outpatient Department, Administrative Department of the President of the Russian FederationBackground. Immune thrombocytopenia (ITP), or idiopathic thrombocytopenic purpura, is a hematological autoimmune disease characterized by bleeding and an isolated decrease in platelet count <100 × 109 / l. The decision to start treatment for ITP depends on several factors. The ITP treatment strategy is based on the clinical symptoms, with a focus on reducing the risk of severe bleeding and increasing platelet counts. Aim. To evaluate the efficacy of 2nd line therapy with the thrombopoietin receptor agonist eltrombopag in patients with ITP. Materials and methods. 490 patients with ITP are under observation at the center for orphan diseases of M. F. Vladimirskiy Moscow Regional Research Clinical Institute. The present study included 186 patients with primary ITP after 1st line glucocorticosteroid therapy. eltrombopag, a thrombopoietin receptor agonist, was prescribed as the 2nd line of therapy. Results. The median platelet count prior to eltrombopag therapy in all patients was 27.5 × 109 / l. after eltrombopag therapy, a significant (by 490 %) increase in platelet levels (median 135 × 109 / l) and a complete response according to clinical recommendations were noted. Conclusion. Glucocorticosteroids (prednisolone, dexamethasone) remain the drugs of choice for the 1st line of therapy. Treatment with drugs of this group in most cases allows achieving an optimal platelet level and preventing bleeding. In case of inefficiency, intolerance, occurrence of side effects, the appointment of thrombopoietin receptor agonists eltrombopag or romiplostim is recommended. therapy with eltrombopag at a dose of 50 mg daily for several weeks has been able to achieve an increase in platelet levels, correct hemorrhagic syndrome, reduce the number of side effects during first-line glucocorticosteroid therapy, and improve the patient’s quality of life.https://oncohematology.abvpress.ru/ongm/article/view/837immune thrombocytopenic purpuraimmune thrombocytopeniathrombocytopeniaromiplostimeltrombopaghemorrhagic syndrome |
| spellingShingle | S. G. Zakharov T. A. Mitina R. V. Vardanyan Z. R. Tekeeva I. N. Kontievskiy Yu. Yu. Chuksina A. V. Zakharova Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia Онкогематология immune thrombocytopenic purpura immune thrombocytopenia thrombocytopenia romiplostim eltrombopag hemorrhagic syndrome |
| title | Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia |
| title_full | Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia |
| title_fullStr | Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia |
| title_full_unstemmed | Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia |
| title_short | Experience of 2<sup>nd</sup> line therapy with eltrombopag in patients with immune thrombocytopenia |
| title_sort | experience of 2 sup nd sup line therapy with eltrombopag in patients with immune thrombocytopenia |
| topic | immune thrombocytopenic purpura immune thrombocytopenia thrombocytopenia romiplostim eltrombopag hemorrhagic syndrome |
| url | https://oncohematology.abvpress.ru/ongm/article/view/837 |
| work_keys_str_mv | AT sgzakharov experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT tamitina experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT rvvardanyan experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT zrtekeeva experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT inkontievskiy experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT yuyuchuksina experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia AT avzakharova experienceof2supndsuplinetherapywitheltrombopaginpatientswithimmunethrombocytopenia |