Eltrombopag Improves Refractory Thrombocytopenia in a Patient with Systemic Lupus Erythematosus

Abstract

A 42-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital for evaluation of severe thrombocytopenia. She was treated with steroids, intravenous cyclophosphamide, intravenous immunoglobulin, and plasma exchange, but her thrombocytopenia did not improve. Renal biopsy showed class IV-S(C) + V lupus nephritis, according to the classification of the International Society of Nephrology/Renal Pathology Society. The PA-IgG and serum thrombopoietin (TPO) levels were elevated. Her thrombocytopenia responded to off-label administration of eltrombopag, which was discontinued after 42 months. At 18 months after stopping eltrombopag, the platelet count was 19.3 × 104/μL. Eltrombopag may be a therapeutic option for SLE patients with severe thrombocytopenia refractory to conventional therapy.

Knowledge map of thrombopoietin receptor agonists: A bibliometric analysis

“…TPO-RAs, especially eltrombopag, have shown satisfactory efficacy and well-tolerability in other off-label indications, including SARS-CoV-2 related [ 50 ] or vaccine-induced [ 51 ] thrombocytopenia, and refractory thrombocytopenia in systemic lupus erythematosus [ 52 ] or pregnant women [ 53 , 54 ]. Other common OLDUs include chemotherapy-induced [ 55 ] or inherited thrombocytopenia [ [56] , [57] , [58] ], and myelodysplastic syndromes [ 59 , 60 ].…”

Successful Treatment of Systemic Lupus Erythematosus-Associated Thrombocytopenia with Eltrombopag: A Report of Two Cases and Literature Review

“… 7 Today, it is believed that conventional therapies are effective in autoantibody-mediated peripheral destruction of platelets whereas new agent eltrombopag is effective in impaired platelet production due to autoantibodies related to bone marrow-derived-megakaryocytes. 8 …”