Use of eltrombopag after romiplostim in primary immune thrombocytopenia

Autores de IIS La Fe

• Maria Eva Mingot Castellano

  Autor

• Jose Manuel Maroñas Andrade

  Autor

• Rosario Alonso Estellés

  Autor

• Isidro Jarque Ramos

  Autor

Participantes ajenos a IIS La Fe

• González-Porras JR
• Caparrós I
• Arratibel MC
• Fernández-Fuertes F
• Cortti MJ
• Pascual C
• Sánchez-González B
• Bernat S
• Fuertes-Palacio MA
• Vázquez-Paganini JA
• Olivera PE
• Alvarez-Román MT
• Cortés M
• Martínez-Robles V
• Díaz-Gálvez FJ
• Calbacho M
• Fernández-Miñano C
• Garcia-Frade J
• González-López TJ

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador Principal

  Marta Montero Alonso

Abstract

The thrombopoietin receptor agonists (THPO-RAs), romiplostim and eltrombopag, are effective and safe in immune thrombocytopenia (ITP). However, the value of their sequential use when no response is achieved or when adverse events occur with one THPO-RA has not been clearly established. Here we retrospectively evaluated 51 primary ITP adult patients treated with romiplostim followed by eltrombopag. The median age of our cohort was 49 (range, 18-83) years. There were 32 women and 19 men. The median duration of romiplostim use before switching to eltrombopag was 12 (interquartile range 5-21) months. The reasons for switching were: lack of efficacy (n=25), patient preference (n=16), platelet-count fluctuation (n=6) and side-effects (n=4). The response rate to eltrombopag was 80% (41/51), including 67% (n=35) complete responses. After a median follow-up of 14months, 31 patients maintained their response. Efficacy was maintained after switching in all patients in the patient preference, platelet-count fluctuation and side-effect groups. 33% of patients experienced one or more adverse events during treatment with eltrombopag. We consider the use of eltrombopag after romiplostim for treating ITP to be effective and safe. Response to eltrombopag was related to the cause of romiplostim discontinuation.

Keywords

• immune thrombocytopenia; eltrombopag; romiplostim; efficacy; switching