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Eltrombopag

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https://www.readbyqxmd.com/read/27913466/nontransplant-therapy-for-bone-marrow-failure
#1
Danielle M Townsley, Thomas Winkler
Nontransplant therapeutic options for acquired and constitutional aplastic anemia have significantly expanded during the last 5 years. In the future, transplant may be required less frequently. That trilineage hematologic responses could be achieved with the single agent eltrombopag in refractory aplastic anemia promotes new interest in growth factors after years of failed trials using other growth factor agents. Preliminary results adding eltrombopag to immunosuppressive therapy are promising, but long-term follow-up data evaluating clonal evolution rates are required before promoting its standard use in treatment-naive disease...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27903709/eltrombopag-a-potent-stimulator-of-megakaryopoiesis
#2
EDITORIAL
Hana Raslova, William Vainchenker, Isabelle Plo
No abstract text is available yet for this article.
December 2016: Haematologica
https://www.readbyqxmd.com/read/27890262/what-is-the-role-of-novel-thrombopoietic-agents-in-the-management-of-acute-leukemia
#3
REVIEW
David J Kuter
The role of novel thrombopoietic agents in the management of acute leukemia is a tale of two molecules, romiplostim and eltrombopag. Both are thrombopoietin (TPO) receptor agonists with somewhat different mechanisms of action. Romiplostim is a peptide TPO receptor agonist that activates the TPO receptor by binding to it just like TPO. Eltrombopag is a nonpeptide TPO receptor agonist that activates the TPO receptor by binding to the transmembrane domain. Both TPO receptor agonists increase platelet counts in healthy humans and in those with immune thrombocytopenia...
December 2016: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/27885890/use-of-a-thrombopoietin-receptor-agonist-in-von-willebrand-disease-type-2b-p-v1316m-with-severe-thrombocytopenia-and-intracranial-hemorrhage
#4
O Espitia, C Ternisien, C Agard, P Boisseau, C V Denis, M Fouassier
We present here a 63-year old woman with a long history of immune thrombocytopenia. She was hospitalized for a traumatic intracranial hemorrhage with thrombocytopenia. Following inefficient treatment of four platelet transfusions, immunoglobulins, and corticosteroids, we initiated treatment with a thrombopoietin (TPO) receptor agonist (eltrombopag 25 mg/d) with a good efficacy. Her mother and sister also had chronic thrombocytopenia. Clinical history, hemostasis results, and gene analysis revealed von Willebrand disease (VWD) type 2B with the mutation (c...
November 25, 2016: Platelets
https://www.readbyqxmd.com/read/27800187/the-use-of-thrombopoietin-receptor-agonists-for-correction-of-thrombocytopenia-prior-to-elective-procedures-in-chronic-liver-diseases-review-of-current-evidence
#5
REVIEW
Kamran Qureshi, Shyam Patel, Andrew Meillier
Patients with chronic liver diseases (CLD) undergo a range of invasive procedures during their clinical lifetime. Various hemostatic abnormalities are frequently identified during the periprocedural work-up; including thrombocytopenia. Thrombocytopenia of cirrhosis is multifactorial in origin, and decreased activity of thrombopoietin has been identified to be a major cause. Liver is an important site of thrombopoietin production and its levels are decreased in patients with cirrhosis. Severe thrombocytopenia (platelet counts < 60-75,000/µL) is associated with increased risk of bleeding with invasive procedures...
2016: International Journal of Hepatology
https://www.readbyqxmd.com/read/27797129/alternative-agents-to-prophylactic-platelet-transfusion-for-preventing-bleeding-in-people-with-thrombocytopenia-due-to-chronic-bone-marrow-failure-a-meta-analysis-and-systematic-review
#6
REVIEW
Michael Desborough, Andreas V Hadjinicolaou, Anna Chaimani, Marialena Trivella, Paresh Vyas, Carolyn Doree, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: People with thrombocytopenia due to bone marrow failure are vulnerable to bleeding. Platelet transfusions have limited efficacy in this setting and alternative agents that could replace, or reduce platelet transfusion, and are effective at reducing bleeding are needed. OBJECTIVES: To compare the relative efficacy of different interventions for patients with thrombocytopenia due to chronic bone marrow failure and to derive a hierarchy of potential alternative treatments to platelet transfusions...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27793553/-thrombosis-during-thrombopoietin-receptor-agonist-treatment-for-immune-thrombocytopenia-a-french-multicentric-observational-study
#7
E Weber, G Moulis, M Mahévas, C Guy, B Lioger, I Durieu, M Hunault, M Ramanantsoa, B Royer, A Default, M-C Pérault-Pochat, L Moachon, N Bernard, G Bardy, A-P Jonville-Bera, H Geniaux, B Godeau, P Cathébras
INTRODUCTION: Thrombopoietin-receptor agonists (TPO-RA) are marketed for immune thrombocytopenia (ITP). They have been associated to thrombosis occurrence in randomized controlled trials. However, the characteristics of these thromboses in the real-life practice as well as their management are poorly known. The objectives of this study were to determine the risk factors, circumstances and management of thrombosis occurring during exposure to TPO-RA in ITP. METHODS: We carried out a multicentre retrospective study in France...
October 25, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27781025/thrombopoietin-receptor-agonists-are-often-ineffective-in-immune-thrombocytopenia-and-or-cause-adverse-reactions-results-from-one-hand
#8
Fabian Depré, Nasra Aboud, Frauke Ringel, Abdulgabar Salama
BACKGROUND: Eltrombopag and romiplostim are thrombopoietin receptor agonists (TPOs) that have been increasingly used for the treatment of immune thrombocytopenia (ITP). Based on our experience, the incidence of abortive treatment with these drugs and the occurrence of adverse reactions that lead to therapy break-off despite response are higher than has been previously suggested. METHODS: During the last 8 years, a total of 65 patients were treated with eltrombopag and/or romiplostim at our institute...
September 2016: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/27773073/eltrombopag-liver-toxicity-kidney-injury-or-assay-interference
#9
Kay Weng Choy, Nilika Wijeratne, James C G Doery
No abstract text is available yet for this article.
February 2016: Pathology
https://www.readbyqxmd.com/read/27762119/life-threatening-thrombo-embolic-events-in-a-case-of-dengue-hemorrhagic-fever
#10
Arun Agarwal, Samiksha Sharma, Mala Airun
In Dengue Hemorrhagic Fever (DHF), hemorrhagic manifestations are common but thrombotic events are uncommonly reported, despite the wide range of increased procoagulant activity during Dengue Fever illness. We report a case of a 55-year-old man of Asian Indian ethnicity who developed large vein thrombotic event -Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) in the acute phase of DHF. His condition was further complicated by associated thrombocytopenia. The etiological connections between dengue viral infection with thrombocytopenia, DVT/PE and abnormal thrombophilia profile as well as the treatment dilemmas posed in treating a patient of DF with hemorrhagic manifestations and associated DVT/PE, and the role of eltrombopag are discussed...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27734464/multicentre-randomised-phase-iii-study-of-the-efficacy-and-safety-of-eltrombopag-in-chinese-patients-with-chronic-immune-thrombocytopenia
#11
Renchi Yang, Junmin Li, Jie Jin, Meijuan Huang, Ziqiang Yu, Xiaojun Xu, Xiaohui Zhang, Ming Hou
Eltrombopag, a thrombopoietin receptor agonist, raises platelet counts and reduces bleeding in patients with immune thrombocytopenia (ITP). In Chinese patients, eltrombopag was evaluated at an initial dose of 25 mg, vs. 50 mg for non-Asians, because the plasma exposure of eltrombopag is higher in East Asians. A multicentre, double-blind, randomised, placebo-controlled, 8-week, phase III study enrolled 155 patients with chronic, previously treated ITP. Dosage could be adjusted (25-75 mg/day) to maintain platelet counts 50-250 × 10(9) /l...
October 13, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27725585/aplastic-anemia
#12
Kensuke Usuki
Treatments of aplastic anemia are comprised of supportive therapy and aplastic anemia-specific therapy aimed at restoring hematopoiesis. Supportive therapies include transfusion, G-CSF, and the administration of iron chelation agents, as well as dealing specifically with individual symptoms. Aplastic anemia-specific treatments given with the aim of achieving hematopoietic recovery include immunosuppressive therapy, allogeneic hematopoietic stem cell transplantation, and anabolic hormone therapy. Although transplantation provides complete recovery of hematopoiesis (cure), there is a risk of death due to transplant-related complications...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27695288/eltrombopag-for-the-treatment-of-aplastic-anemia-current-perspectives
#13
Su Han Lum, John D Grainger
Aplastic anemia (AA) is a potential life-threatening hematopoietic stem cell (HSC) disorder resulting in cytopenia. The mainstays of treatment for AA are definitive therapy to restore HSCs and supportive measures to ameliorate cytopenia-related complications. The standard definitive therapy is HSC transplantation for young and medically fit patients with suitable donors and immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporine for the remaining patients. A significant proportion of patients are refractory to IST or relapse after IST...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27671102/eltrombopag-thrombopoietin-receptor-agonist-and-plasmapheresis-as-rescue-therapy-of-acute-post-renal-transplant-immune-thrombocytopenia-in-a-child-with-schimke-immuno-osseous-dysplasia-case-report
#14
Ryszard Grenda, Wioletta Jarmużek, Joanna Latoszyńska, Sylwester Prokurat, Jacek Rubik
SIOD is rare disorder related to SMARCAL1 or SMARCAL2 gene mutation, including (among other comorbidities) T-cell immunodeficiency, nephrotic syndrome, and renal failure. Up to 22% of primary patients may develop various autoimmune disorders. We report the case of 11-year-old male with SIOD, who presented ITP at 2 years after renal transplantation with decrease in platelet count (from normal) to 56 000/μL and then (gradually) to 2000/μL. There was no effect of iv. methylprednisolone/dexamethasone. As the presence of antibodies against GPIIb/IIIa, GPIb, and GPIaIIa platelet glycoproteins was confirmed, patient was given 50 g of IVIG and then was put on plasmapheresis; however, both showed poor direct effect...
September 26, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27650208/management-of-primary-immune-thrombocytopenia-with-eltrombopag-in-a-patient-with-recent-acute-coronary-syndrome
#15
Nuria Bermejo, Raúl Sigüenza, Fátima Ibáñez
No abstract text is available yet for this article.
September 17, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27633469/cytomegalovirus-associated-thrombocytopenia-treated-with-thrombopoietin-receptor-agonist
#16
J D Simpson, G V Matthews, T A Brighton, J E Joseph
Symptomatic cytomegalovirus (CMV) in immunocompetent individuals is an uncommon, yet recognised, phenomenon. This report discusses a case of CMV-associated thrombocytopenia refractory to immunomodulation and antivirals. Ultimately, a clinicopathological response was attained with eltrombopag. This is the first report of the efficacy of thrombopoietin receptor agonists in this context. This experience provides insight into possible pathogenic mechanisms of CMV-associated thrombocytopenia and presents a therapeutic option...
September 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27617608/morbilliform-eruption-related-to-eltrombopag-emerging-data-on-the-cutaneous-toxicity-of-thrombopoietin-receptor-agonists
#17
Tiana Kazemi, Sabrina Martin, Scott Worswick
Eltrombopag is a thrombopoietin mimetic used for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenia, hepatitis C patients undergoing antiviral therapy, and thrombocytopenia secondary to aplastic anemia that is refractory to immunosuppressive therapy. We report a case of a 25-year-old man with a history of aplastic anemia who presented with fever and a monomorphic papular rash. Subsequent labs, biopsy, and clinical course favored drug-induced cutaneous toxicity, with eltrombopag as the likely culprit...
June 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/27605856/a-case-of-refractory-immune-thrombocytopenia-in-pregnancy-managed-with-elthrombopag
#18
Jyothis Purushothaman, Kochuthresia J Puthumana, Aswath Kumar, Susheela J Innah, Sareena Gilvaz
Immune thrombocytopenic purpura is a common acquired autoimmune disorder defined by a low platelet count secondary to accelerated platelet destruction or impaired thrombopoesis by anti-platelet antibodies. Thrombopoietin (TPO)-mimetic drugs such as eltrombopag and romiplostim have been used successfully in many nonpregnant individuals with immune thrombocytopenia (ITP) but studies based on its effects in pregnancy are limited. A 27-year-old multigravida who is a known case of ITP with bad obstetric history was referred to the Department of Obstetrics and Gynecology at 26 weeks of gestation with complaints of mucosal bleeding and recurrent abortions...
July 2016: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/27597907/simultaneous-manifestation-of-chronic-myelomonocytic-leukemia-and-multiple-myeloma-during-treatment-by-prednisolone-and-eltrombopag-for-immune-mediated-thrombocytopenic-purpura
#19
Masao Hagihara, Morihiro Inoue, Kenichiro Kodama, Tomoyuki Uchida, Jian Hua
An 80-year-old man was admitted to our hospital because of severe thrombocytopenia. He was diagnosed with idiopathic thrombocytopenia, and prednisolone together with eltrombopag was started, leading to significant improvement of platelet counts. Four years later, there was a prominent increase of peripheral blood monocytes, which was accompanied by recurrence of thrombocytopenia. Bone marrow aspirates and serum electrophoresis revealed coexistence of chronic myelomonocytic leukemia (CMML) and multiple myeloma (MM)...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27572890/tolerability-and-efficacy-of-eltrombopag-in-chronic-immune-thrombocytopenia-meta-analysis-of-randomized-controlled-trials
#20
Ahmed Saber Elgebaly, Gehad El Ashal, Mohamed Elfil, Ahmed Menshawy
BACKGROUND: Eltrombopag is an oral thrombopoietin receptor agonist that stimulates the production of normally functioning platelets. The aim of this meta-analysis is to synthesize evidence about the safety and efficacy of eltrombopag for both adult and children with primary immune thrombocytopenia (ITP). METHODS: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central was conducted. Records were screened for eligible studies, and data were extracted and synthesized using Review Manager for Windows...
August 29, 2016: Clinical and Applied Thrombosis/hemostasis
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