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https://www.readbyqxmd.com/read/28411254/safety-and-efficacy-of-romiplostim-in-splenectomized-and-nonsplenectomized-patients-with-primary-immune-thrombocytopenia
#1
Douglas B Cines, Jeffrey Wasser, Francesco Rodeghiero, Beng H Chong, Michael Steurer, Drew Provan, Roger Lyons, Jaime Garcia-Chavez, Nancy Carpenter, Xuena Wang, Melissa Eisen
Primary immune thrombocytopenia is an autoimmune disorder characterized by increased platelet destruction and insufficient platelet production without another identified underlying disorder. Splenectomy may alter responsiveness to treatment and/or increase the risk of thrombosis, infection, and pulmonary hypertension. This analysis evaluated the safety and efficacy of the thrombopoietin receptor agonist romiplostim in splenectomized and nonsplenectomized adults with primary immune thrombocytopenia. Data were pooled across 13 completed clinical studies in adults with immune thrombocytopenia from 2002-2014...
April 14, 2017: Haematologica
https://www.readbyqxmd.com/read/28408804/spotlight-on-romiplostim-in-the-treatment-of-children-with-chronic-immune-thrombocytopenia-design-development-and-potential-place-in-therapy
#2
REVIEW
David Buchbinder, Diane Nugent, Loan Hsieh
Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia. In approximately one-third of cases, the duration of thrombocytopenia will extend beyond 12 months consistent with a diagnosis of chronic ITP. Minor bleeding manifestations are common in chronic ITP while severe or life-threatening bleeding complications are uncommon. Moreover, spontaneous resolution occurs in the majority of children with chronic ITP necessitating treatment in only those children with ongoing bleeding manifestations or impairment in health-related quality of life (HRQOL)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28331458/immune-thrombocytopenia-and-obesity-predictive-relationship
#3
Ehab Hanafy, Mohammed Al Pakra
BACKGROUND: Chronic refractory immune thrombocytopenia (ITP) is defined as the failure of any modality to maintain the platelet count above 20 × 10(3)/μL for an appreciable time without unacceptable toxicity. To date, certain predictive factors have been associated with refractory ITP. However, none of the published studies has declared the possible association between obesity and refractory ITP. CASE REPORTS: We present the cases of 3 children with ITP who failed to achieve remission on different therapeutic approaches including rituximab, vincristine, and romiplostim...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28295192/state-of-the-art-how-i-manage-immune-thrombocytopenia
#4
REVIEW
Nichola Cooper
The management of patients with immune thrombocytopenia (ITP) is rapidly evolving. Over the last 15 years, a number of novel treatments have improved practice, with many steroid-sparing agents and a reduction in the progression to splenectomy. Although this has improved clinical care, many therapeutic challenges remain. There is no diagnostic test, no biomarkers to direct treatment and few comparative studies to help management decisions. Development of up to date guidelines is difficult with little high-grade evidence...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28293407/thrombocytopenia-in-patients-with-chronic-hepatitis-c-virus-infection
#5
REVIEW
Sumit Dahal, Smrity Upadhyay, Rashmi Banjade, Prajwal Dhakal, Nabin Khanal, Vijaya Raj Bhatt
Thrombocytopenia in patients with chronic hepatitis C virus (HCV) infection is a major problem. The pathophysiology is multifactorial, with auto-immunogenicity, direct bone marrow suppression, hypersplenism, decreased production of thrombopoietin and therapeutic adverse effect all contributing to thrombocytopenia in different measures. The greatest challenge in the care of chronic HCV patients with thrombocytopenia is the difficulty in initiating or maintaining IFN containing anti-viral therapy. Although at present, it is possible to avoid this challenge with the use of the sole Direct Antiviral Agents (DAAs) as the primary treatment modality, thrombocytopenia remains of particular interest, especially in cases of advanced liver disease...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28271416/bleeding-tendency-and-platelet-function-during-treatment-with-romiplostim-in-children-with-severe-immune-thrombocytopenic-purpura
#6
Elena V Suntsova, Irina M Demina, Anastasia A Ignatova, Nikolay M Ershov, Natalia M Trubina, Juliya Dobrynina, Irina V Serkova, Zhanna S Supik, Ekaterina V Orekhova, Lili A Hachatryan, Natalia N Kotskaya, Aleksey V Pshonkin, Aleksey A Maschan, Galina A Novichkova, Mikhail A Panteleev
It has been suggested that platelet function in chronic immune thrombocytopenic purpura (ITP) may be abnormal. Thrombopoietin mimetics used for treatment can affect it, but the data remain limited. We investigated platelet function of 20 children diagnosed with severe ITP (aged 1-16 years, 12 females and eight males). Platelet functional activity in whole blood was characterized by flow cytometry before and after stimulation with SFLLRN plus collagen-related peptide. Levels of CD42b, PAC1, and CD62P, but not CD61 or annexin V, were significantly increased (P < 0...
March 7, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28174643/romiplostim-therapy-as-a-second-line-treatment-before-splenectomy-for-refractory-immune-thrombocytopenia-in-a-cirrhotic-patient-with-iatrogenic-cushing-syndrome-secondary-to-corticosteroids
#7
Teresa Casanovas Taltavull, Maria Carmen Peña-Cala
Our case report discusses the usefulness of administering romiplostim as a second-line treatment before splenectomy in a cirrhotic patient with immune thrombocytopenia who developed corticosteroid-induced Cushing's syndrome. Corticosteroids were tapered and consequently withdrawn. The patient made a full recovery postsplenectomy.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28151387/bidirectional-inefficacy-or-intolerability-of-thrombopoietin-receptor-agonists-new-data-and-a-concise-review
#8
Fabian Depré, Nasra Aboud, Beate Mayer, Abdulgabar Salama
BACKGROUND: There is evidence that the thrombopoietin-receptor agonists romiplostim and eltrombopag may have different therapeutic values and adverse reaction profiles. Here we present new data and provide a review of all studies dealing with switching between these two drugs. MATERIALS AND METHODS: A total of 89 patients (38 males and 51 females, aged between 14-87 years) were treated with eltrombopag and/or romiplostim between 2007 and 2016 at our institution...
January 25, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28150377/romiplostim-for-therapy-related-thrombocytopenia-in-pediatric-malignancies
#9
Amanda E Jacobson, Nilay Shah, Bhuvana A Setty
Therapy-related thrombocytopenia (TRT), due to chemotherapy and/or radiation therapy, is common with pediatric cancer treatments, and it can result in dose reductions and therapy delays. Romiplostim, a thrombopoietin mimetic, is efficacious as a second-line treatment for immune thrombocytopenia in children and for TRT in adult cancer patients. However, there are no data for its use for TRT in children. We report a case series of five children treated for solid tumors where romiplostim was used without adverse effects to successfully resolve and prevent therapy-limiting refractory TRT...
February 2, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28038671/erratum-to-treatment-of-5-dogs-with-immune-mediated-thrombocytopenia-using-romiplostim
#10
Barbara Kohn, Gürkan Bal, Aleksandra Chirek, Sina Rehbein, Abdulgabar Salama
No abstract text is available yet for this article.
December 30, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/28034281/is-there-any-role-for-splenectomy-in-adulthood-onset-chronic-immune-thrombocytopenia-in-the-era-of-tpo-receptors-agonists-a-critical-overview
#11
Vibor Milunovic, Inga Mandac Rogulj, Slobodanka Kolonic Ostojic
Immune thrombocytopenia (ITP) in adulthood is characterized by chronic relapsing course. Despite the efficacious first line treatment (corticosteroid, intravenous immunoglobulin), majority of patients will enter the chronic phase warranting another treatment approach. Until recently, splenectomy performed in ITP chronic phase represented the standard of care with long-term remissions in more than 70% of patients, but however has never been tested in clinical trials. However, with the advances of our understanding of ITP pathophysiology and the shifting focus on megakaryocyte impairment, novel drugs were introduced in treatment paradigm, mainly trombopoietin receptor agonists (TPO-RAs); romiplostim and eltrombopag...
December 29, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/27971699/eltrombopag-vs-romiplostim-in-adult-patients-with-chronic-immune-trombocytopenia-economic-evaluation
#12
M Frolov, E Pyadushkina, M Avxentyeva
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27890262/what-is-the-role-of-novel-thrombopoietic-agents-in-the-management-of-acute-leukemia
#13
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/27800187/the-use-of-thrombopoietin-receptor-agonists-for-correction-of-thrombocytopenia-prior-to-elective-procedures-in-chronic-liver-diseases-review-of-current-evidence
#14
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
#15
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
#16
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
#17
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/27764999/a-fatal-case-of-transplantation-mediated-alloimmune-thrombocytopenia-following-liver-transplantation
#18
Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
April 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27709451/successful-early-romiplostim-use-in-a-case-of-severe-immune-thrombocytopenia-with-critical-carotid-arterial-injury
#19
Reiko Watanabe, Takayuki Tabayashi, Tatsuki Tomikawa, Morihiko Sagawa, Tomoe Anan-Nemoto, Yuta Kimura, Yasuyuki Takahashi, Michihide Tokuhira, Satoshi Otaki, Hidenori Oi, Makoto Sawano, Satoshi Sugiyama, Masahiro Kizaki
Thrombopoietin receptor (TPO-R) agonists have been shown to be effective in refractory chronic immune thrombocytopenia (ITP); however, their efficacy in patients under critical care is not known. We report the case of a female patient with a newly diagnosed ITP who experienced severe bleeding from an external wound. The patient was administered the standard treatments for ITP, which are high-dose intravenous immunoglobulin (IVIg) and corticosteroids. However, following failure of these treatments, we administered romiplostim on day 6 after the onset of ITP...
January 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/27605856/a-case-of-refractory-immune-thrombocytopenia-in-pregnancy-managed-with-elthrombopag
#20
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
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