Long-term safety and efficacy of romiplostim for treatment of immune thrombocytopenia

Vishnu, Prakash; Aboulafia, David M.

doi:10.2147/jbm.s80646

Cited by 13 publications

(9 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, it was shown that the optimum dose of RP was 50 μg/kg of body weight/day (Fig. 1A ), which is 50-fold higher than the clinically used dose (1 μg/kg of body weight/day) but within the range showing no toxicity 26 . Moreover, in our preliminary trials using X-rays to overcome mortality due to 8 Gy of irradiation, mice that received 50 µg/kg of RP twice per day (12-hour intervals) for 3 consecutive days achieved a 100% 30-day survival rate (data not shown).…”

Section: Discussionmentioning

confidence: 47%

The thrombopoietin mimetic romiplostim leads to the complete rescue of mice exposed to lethal ionizing radiation

Yamaguchi

Hirouchi

Yokoyama

et al. 2018

Sci Rep

View full text Add to dashboard Cite

For the primary treatment of emergency exposure to high-dose radiation, such as in the event of a radiation accident, the top priority is the reconstitution and restoration of haematopoiesis. In most radiation accidents, drug therapy is chosen as the most suitable treatment; the chosen drug should already be approved domestically, stably supplied and regularly stockpiled. In the present study, a single administration of romiplostim (RP), an approved thrombopoietin receptor agonist, produced a 100% survival rate in C57BL/6 J mice exposed to a lethal dose (7 Gy) of 137Cs γ-rays, and all irradiated mice survived for more than 30 days with both 3- and 5-day consecutive administrations. By day 30, the peripheral blood cells, bone marrow cells and haematopoietic progenitor cells of the RP-administered irradiated mice had all recovered to a level that was not significantly different from that in non-irradiated mice. In contrast to myelosuppression, which did not fully recover until day 30, the expression of several bone marrow cell surface antigens recovered sooner, and DNA repair concurrently increased in haematopoietic cells, speeding the resolution of double strand breaks and reducing the rates of apoptosis. These findings suggest that RP may be a clinic-ready countermeasure to treat victims of radiation accidents.

show abstract

Section: Discussionmentioning

confidence: 47%

The thrombopoietin mimetic romiplostim leads to the complete rescue of mice exposed to lethal ionizing radiation

Yamaguchi

Hirouchi

Yokoyama

et al. 2018

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Longer-term nonrandomized observational studies have suggested a modestly higher rate of thrombosis in patients with ITP treated with TPO-RAs as compared with similar observational studies of patients with ITP treated with immunosuppressive agents. 57,58 Therefore, the thrombotic potential of TPO-RAs should be a consideration in patients with ITP with significant risk factors for venous or arterial thrombosis.…”

Section: What Adverse Events Occur and How To Monitor For Themmentioning

confidence: 99%

Optimal use of thrombopoietin receptor agonists in immune thrombocytopenia

Al‐Samkari

Kuter

2019

Therapeutic Advances in Hematology

View full text Add to dashboard Cite

The thrombopoietin receptor agonists (TPO-RAs) are a class of platelet growth factors commonly used to treat immune thrombocytopenia (ITP). There are three agents that have been investigated for the treatment of chronic ITP: the peptide agent romiplostim and the small molecule agents eltrombopag and avatrombopag. These agents offer a higher clinical response rate than most other ITP therapies but may require indefinite use. This review is a critical appraisal of the TPO-RAs in adult ITP, defining the optimal patient groups to receive these agents and assisting the hematologist with agent choice, goals of treatment, dosing strategies, and toxicity management. Use of endogenous thrombopoietin levels to predict response to eltrombopag and romiplostim treatment is discussed and alternative dosing protocols suited for certain patient subgroups are described. Finally, indications for discontinuation and combination therapy with other agents are considered.

show abstract

“…The endothelial recirculation of the crystallized domain elongates the half-life of the polypeptide [34]. Subcutaneous administration of romiplostim increases platelet count and reduces bleeding episodes in ITP patients [35]. With an aim to evaluate the efficacy of romiplostim by measuring the stable platelet response and safety of treatment, two parallel placebo-controlled Phase III trials, involving splenectomized and non-splenectomized ITP patients, with mean three platelet count ≤30 X 109/L were conducted.…”

Section: Reviewmentioning

confidence: 99%

“…No antibodies against romiplostim or thrombopoietin were produced. Side effects were alike in both the romiplostim and placebo-treated groups [35-36]. Only two romiplostim-treated patients reported adverse reactions involving increased bone marrow reticulin in one patient and peripheral disease and atrial fibrillation in another patient.…”

Section: Reviewmentioning

confidence: 99%

“…Only two romiplostim-treated patients reported adverse reactions involving increased bone marrow reticulin in one patient and peripheral disease and atrial fibrillation in another patient. However, bone marrow reticulin returned to the baseline level on the discontinuation of romiplostim [35]. In another open-label extension study from August 2004 to January 2010 involving adult ITP patients receiving romiplostim for about 78 weeks with an average weekly dose of 4 mcg/kg, 94.5% patients were found to maintain a platelet count of ≥50×109/L and about 82% patients could successfully administer romiplostim at home [37].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Thrombopoietin Receptor Agonists: Can These Be the Future Answer to the Deadly Thrombocytopenia in Dengue Fever?

Roy

2019

Cureus

View full text Add to dashboard Cite

Dengue is considered the most prevalent mosquito-borne viral disease worldwide and sometimes turns out to be life-threatening. Thrombocytopenia is frequently observed in mild and severe cases of dengue. Severe thrombocytopenia, with a platelet count much below the normal range and hemorrhagic manifestation, is considered a fatal consequence of dengue that needs proper and timely management. The development of the dengue vaccine is quite challenging due to the existence of four different serotypes of the virus. Currently, neither a specific antiviral therapy nor a vaccine is available, and the common treatment modalities include fluid replacement therapy and platelet transfusions. Besides dengue, thrombocytopenia is correlated with many other diseases, particularly immune thrombocytopenic purpura (ITP). Thrombopoietin receptor (TPO-R) agonist, which is responsible for increasing platelet count, is a novel treatment option for chronic ITP patients. At present, two TPO-R agonists - eltrombopag and romiplostim - approved by the US Food and Drug Administration (USFDA) have been successfully used for the treatment of chronic ITP and other thrombocytopenic conditions. However, to date, only a single case study reported the use of romiplostim to enhance the platelet count in a myeloma patient suffering from dengue-associated thrombocytopenia. The objective of this review is to propose to the medical fraternity to consider using these TPO-R agonists to treat dengue hemorrhagic patients with thrombocytopenia and to conduct relevant researches to find out the usefulness of these molecules. This review is completely based on hypotheses and articles showing the positive response with romiplostim in dengue after going through a web-based search on various search engines. Furthermore, this review highlights the need for good-quality, randomized controlled trials and meta-analyses to detect the safety and efficacy of romiplostim and eltrombopag therapy for patients suffering from dengue-related thrombocytopenia.

show abstract

Long-term safety and efficacy of romiplostim for treatment of immune thrombocytopenia

Cited by 13 publications

References 32 publications

The thrombopoietin mimetic romiplostim leads to the complete rescue of mice exposed to lethal ionizing radiation

The thrombopoietin mimetic romiplostim leads to the complete rescue of mice exposed to lethal ionizing radiation

Optimal use of thrombopoietin receptor agonists in immune thrombocytopenia

Thrombopoietin Receptor Agonists: Can These Be the Future Answer to the Deadly Thrombocytopenia in Dengue Fever?

Contact Info

Product

Resources

About