An Eltrombopag Red (Plasma) Alert

Al‐Samkari, Hanny; Goodarzi, Katayoon

doi:10.1159/000508599

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…Avatrombopag offers certain potential advantages over romiplostim and eltrombopag, the first TPO‐RAs approved for the treatment of ITP 10 . In contrast to eltrombopag, another oral TPO‐RA, avatrombopag does not require dietary restrictions around its administration, has no hepatotoxicity signal or need for liver function monitoring, no iron chelator effect, and no potential for discoloration of body fluids, skin, or sclerae 11–14 . While romiplostim also has these advantages, it is a weekly subcutaneous injection, typically administered in the clinic in the U.S., while avatrombopag has the advantage of oral administration.…”

Section: Introductionmentioning

confidence: 99%

Avatrombopag for adults with early versus chronic immune thrombocytopenia

Virk,

Leaf,

Kuter

et al. 2023

American J Hematol

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Avatrombopag is a newer thrombopoietin receptor agonist (TPO‐RA) currently approved to treat chronic ITP (duration >12 months). No studies have yet evaluated the safety and effectiveness of avatrombopag in newly diagnosed ITP (duration <3 months) or persistent ITP (duration 3–12 months), and so its use in these populations is presently off‐label worldwide. We hypothesize that avatrombopag has similar safety and effectiveness irrespective of ITP disease phase. To evaluate this, we performed a multicenter observational cohort study of adults with ITP treated with avatrombopag, comparing patient outcomes by disease phase (newly diagnosed/persistent versus chronic). Seventy‐five patients were included, 23 with newly diagnosed/persistent ITP (17.7 patient‐years of avatrombopag treatment) and 52 with chronic ITP (65.3 patient‐years of avatrombopag treatment). On avatrombopag, 91% of newly diagnosed/persistent patients versus 96% of chronic patients (p = .58) achieved a platelet response (≥50 × 109/L) and 86% versus 81% of patients (p = .78) achieved a complete response (≥100 × 109/L). Median platelet counts on avatrombopag were similar between the two groups (165 × 109/L vs. 129 × 109/L, p = .57). Response durability was high and similar in both groups. No patients in the newly diagnosed/persistent group had a major bleeding event, thromboembolic event or avatrombopag discontinuation for adverse events, compared with 4, 1, and 2, respectively, in the chronic group. Thrombocytosis (platelets ≥400 × 109/L) incidence was similar in the two groups. No other drug‐related adverse events occurred in either group. Avatrombopag was safe and effective in patients with newly diagnosed and persistent ITP, with outcomes numerically, statistically, and clinically similar to patients receiving avatrombopag for chronic ITP.

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Section: Introductionmentioning

confidence: 99%

Avatrombopag for adults with early versus chronic immune thrombocytopenia

Virk,

Leaf,

Kuter

et al. 2023

American J Hematol

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Drugs and Conditions That May Mimic Hemolysis

Jones

Sapatnekar

Bakdash

2022

American Journal of Clinical Pathology

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Objectives Visual inspection of posttransfusion plasma for hemolysis is a key laboratory method in the investigation of possible acute hemolytic transfusion reactions (AHTRs). Many substances and physiologic conditions can mimic hemolysis in vitro. Isolated reports describe specific cases of interference, but a comprehensive listing is lacking. Methods Using an illustrative case, we summarize available literature on substances and conditions that may mimic hemolysis in vitro. We further describe other substances and conditions that may discolor plasma but are unlikely to be mistaken for hemolysis on visual inspection. Results At least 11 substances and conditions have been reported to discolor plasma, in colors ranging from orange to red to brown, including relatively common therapies (eg, eltrombopag, hydroxocobalamin, iron dextran). Other substances are unlikely to be encountered in everyday practice but may mimic hemolysis in particular patient populations. Additional substances may cause plasma discoloration, ranging from blue to green to white, and are associated with a wide variety of therapies and conditions. Conclusions An awareness of the possible preanalytic confounding factors that may mimic hemolysis can aid in the workup of a suspected AHTR. Review of the medical record, use of ancillary testing, and consideration for nonimmune causes of hemolysis can aid in ruling out AHTR.

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An Eltrombopag Red (Plasma) Alert

Cited by 2 publications

References 2 publications

Avatrombopag for adults with early versus chronic immune thrombocytopenia

Avatrombopag for adults with early versus chronic immune thrombocytopenia

Drugs and Conditions That May Mimic Hemolysis

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