Your browser doesn't support javascript.
loading
Lusutrombopag is effective and safe in patients with chronic liver disease and severe thrombocytopenia: a multicenter retrospective study.
Nomoto, Hiroaki; Morimoto, Naoki; Miura, Kouichi; Watanabe, Shunji; Takaoka, Yoshinari; Maeda, Hiroshi; Sasaki, Takahiro; Koyashiki, Yohei; Kurata, Hidekazu; Numao, Norikatsu; Isoda, Norio; Yamamoto, Hironori.
  • Nomoto H; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Morimoto N; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Miura K; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan. miura385@jichi.ac.jp.
  • Watanabe S; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Takaoka Y; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Maeda H; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Sasaki T; Department of Radiology, Jichi Medical University, Shimotsuke, 329-0498, Japan.
  • Koyashiki Y; Department of Radiology, Jichi Medical University, Shimotsuke, 329-0498, Japan.
  • Kurata H; Department of Gastroenterology, Tochigi Medical Center Shimotsuga, Tochigi, 329-4498, Japan.
  • Numao N; Department of Gastroenterology, Haga Red Cross Hospital, Mooka, 321-4308, Japan.
  • Isoda N; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
  • Yamamoto H; Department of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
BMC Gastroenterol ; 20(1): 427, 2020 Dec 14.
Article en En | MEDLINE | ID: mdl-33317473
ABSTRACT

BACKGROUND:

Chronic liver disease (CLD) is often complicated by severe thrombocytopenia (platelet count < 50,000/µL). Platelet transfusion has been a gold standard for increasing the platelet count to prevent hemorrhagic events in such patients. Lusutrombopag, a thrombopoietin receptor agonist, can increase the platelet count in such patients when invasive procedures are scheduled. Former studies on lusutrombopag included patients with a platelet count of > 50,000/µL at baseline the proportions of patients who did not require platelet transfusion were 84-96%, which might be overestimated.

METHODS:

The efficacy and safety of lusutrombopag were retrospectively investigated in CLD patients with platelet count of < 50,000/µL, a criterion for platelet transfusion, in real-world settings. We examined the proportion of patients who did not require platelet transfusion in 31 CLD patients, which exceeded a minimum required sample size (21 patients) calculated by 80% power at a significance level of 5%. Lusutrombopag, 3 mg once daily, was administered 8-18 days before scheduled invasive procedures.

RESULTS:

Among 31 patients who received lusutrombopag, 23 patients (74.2%) patients showed a platelet count of ≥ 50,000/µL (Group A) and did not require platelet transfusion. The remaining 8 patients (25.8%) did not reached platelet ≥ 50,000/µL (Group B). The means of platelet increase were 38,000/µL and 12,000/µL in groups A and B, respectively. A low platelet count at baseline was a characteristic of patients in group B. Among 13 patients who repeatedly used lusutrombopag, lusutrombopag significantly increased the platelet count as the initial treatment. When all repeated uses of lusutrombopag were counted among these 13 patients, platelet transfusion was not required in 82.1% (23/28) of treatments. Although one patient showed portal thrombosis after lusutrombopag treatment, the thrombosis was disappeared by anticoagulant treatment for 35 days. The degree of platelet increase with lusutrombopag was larger than that in their previous platelet transfusion.

CONCLUSIONS:

The proportion of patients who did not require platelet transfusion was 74.2%, which is smaller than that in former studies which included CLD patients with a platelet count of > 50,000/µL. However, lusutrombopag is effective and safe for CLD patients with a platelet count of < 50,000/µL.
Asunto(s)
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trombocitopenia / Hepatopatías Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Año: 2020 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trombocitopenia / Hepatopatías Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Año: 2020 Tipo del documento: Article