SAT-006-Efficacy of oral thrombopoietin receptor agonist lusutrombopag in chronic liver disease by underlying disease aetiology

2019 ◽  
Vol 70 (1) ◽  
pp. e627-e628 ◽  
Author(s):  
Naim Alkhouri ◽  
Michio Imawari ◽  
Namiki Izumi ◽  
Yukio Osaki ◽  
Toshimitsu Ochiai ◽  
...  
2019 ◽  
Vol 38 (4) ◽  
pp. 329-334 ◽  
Author(s):  
Yuki Tsuji ◽  
Hideto Kawaratani ◽  
Koji Ishida ◽  
Daisuke Kaya ◽  
Takuya Kubo ◽  
...  

Aims: Thrombocytopenia is a common complication among patients with chronic liver disease (CLD). To increase platelet counts, lusutrombopag, a small-molecule, second-generation thrombopoietin receptor agonist, was developed in September 2015. Lusutrombopag is mainly used in patients with platelet counts <50,000/µL. However, its usefulness in patients with platelet counts ≥50,000/µL remains unknown. We studied the effectiveness of lusutrombopag administration in patients with platelet counts of ≥50,000/µL. Methods: We evaluated 36 patients who received lusutrombopag for CLD. Changes in platelet counts were evaluated. A treatment response was defined as an increasing platelet count ≥20,000/µL from baseline after drug administration. The differences related to these changes between platelet counts ≥50,000 and <50,000/µL were evaluated. Results: Of the patients, 25 had platelet counts ≥50,000/µL. The increase in platelet count and the date in which it reached a maximum did not significantly differ between the groups. The effectiveness of lusutrombopag did not significantly differ between the groups. In both groups, no adverse reaction was observed during lusutrombopag administration. Conclusion: In this study, we showed the effectiveness of lusutrombopag, which had no complications. This study is the first to report that the effectiveness of lusutrombopag was the same for patients with platelet counts ≥50,000/µL and <50,000/µL.


2020 ◽  
Vol 13 (2) ◽  
pp. 863-866
Author(s):  
Sabah E. Mohamed ◽  
Mohamed A. Yassin

Off-label drug use refers to drug use beyond the specifications authorized for marketing [J Med Case Rep. 2014 Dec;8(1):303]. Eltrombopag is a thrombopoietin receptor agonist that has been used in treating thrombocytopenia due to chronic liver disease (CLD) as an off-label medication. Treatment of thrombocytopenia in patients with CLD constitute a real dilemma as the options are limited and some of them are invasive. However, thrombopoietin receptor agonist has been increasingly used for this purpose. Here we report a 34-year-old woman who has been diagnosed with CLD due to autoimmune hepatitis 20 years ago. Her condition was complicated with portal vein thrombosis, chronic thrombocytopenia, and variceal hemorrhage, and she has been listed as a candidate for liver transplantation. Given her high risk of bleeding, we started her on low dose of eltrombopag (25 mg daily) in order to maintain a platelet level of ≥50 × 103/µL. However, 1 year after initiation of the therapy, she developed left lower limb deep vein thrombosis.


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