Low-Dose Eltrombopag in a Patient with Chronic Idiopathic Thrombocytopenic Purpura Post Sleeve Gastrectomy

Ahmed, Mohanad; Yassin, Mohamad A

doi:10.1159/000507755

Cited by 4 publications

(5 citation statements)

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“…The dose is gradually increased to maintain a minimum platelet count of >50,000/mm³ to prevent bleeding. The dose of eltrombopag is adjusted as follows [ 4 ]: if the patient’s platelets count <50,000/mm³, the dose should be increased gradually to reach a minimum count of 50,000/mm³ (the maximum dose is 75 mg daily). If the patient’s platelet count is between 50,000/mm² and 200,000/mm³, the dose should be maintained with no change.…”

Section: Discussionmentioning

confidence: 99%

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Eltrombopag Dose Adjustment During Infection-Induced Thrombocytosis in a Patient With Chronic Idiopathic Thrombocytopenic Purpura

Ahmed¹,

Abdelmahmuod²,

Ali³

et al. 2021

Cureus

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Idiopathic thrombocytopenic purpura (ITP) is an immune disorder in which antibodies attack platelets, leading to platelet destruction and increased bleeding risk. Standard treatment is to maintain a platelet count sufficient to mitigate the bleeding risk. First-line therapies include steroids and IV immunoglobulins, and second-line therapy includes thrombopoietin receptor agonists like eltrombopag in combination with other medications (e.g., rituximab) to reduce immune attack. Eltrombopag is a nonpeptide oral thrombopoietin (TPO)-receptor agonist that increases platelet counts by binding to and activating the human TPO receptor. While using eltrombopag, the target platelet count range is usually between 50,000/mm³ and 200,000/mm³, so the dose should be adjusted accordingly. However, this dose adjustment is based on platelet count increments in response to eltrombopag administration. Adjusting the dose when the platelet count is elevated due to a different factor can be challenging. Data are not yet available on whether stopping the treatment or reducing the dose will harm the patient or result in an acute drop in platelet count and increased bleeding. We present the case of a 60-year-old woman with ITP on a stable eltrombopag regimen who completed an eltrombopag-free period after developing infection-induced thrombocytosis.

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Section: Discussionmentioning

confidence: 99%

“…Eltrombopag stimulates the bone marrow to produce platelets, and the dosage is adjusted based on the patient’s response to the treatment [ 4 ]. In clinical practice, some patients already on eltrombopag may exhibit an increase in platelet counts due to conditions other than the action of eltrombopag.…”

Section: Introductionmentioning

confidence: 99%

Eltrombopag Dose Adjustment During Infection-Induced Thrombocytosis in a Patient With Chronic Idiopathic Thrombocytopenic Purpura

Ahmed¹,

Abdelmahmuod²,

Ali³

et al. 2021

Cureus

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“…Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by autoantibodies directed against platelet surface antigens that lead to decreased platelet numbers and manifest as skin bleeding or manifested as systemic in severe cases bleeding like intracranial hemorrhage (ICH). ITP can be acquired or inherited disorders 4 …”

Section: Introductionmentioning

confidence: 99%

“…ITP can be acquired or inherited disorders. 4 Eltrombopag (EPAG) is a thrombopoietin agonist that can be used orally to enhance platelet production from the bone marrow. It is used for the treatment of chronic ITP, especially for those who are resistant to steroids.…”

mentioning

confidence: 99%

Eltrombopag and its beneficial role in management of ulcerative Colitis associated with ITP as an upfront therapy case report

Abdelmahmuod

Ali

Ahmed

et al. 2021

Clinical Case Reports

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“…Immune thrombocytopenia (ITP, also called idiopathic thrombocytopenic purpura or immune thrombocytopenic purpura) is an acquired thrombocytopenia caused by autoantibodies against platelet antigens [1]. Thrombocytopenia may be inherited or acquired.…”

Section: Introductionmentioning

confidence: 99%

Steroid-Refractory Chronic Idiopathic Thrombocytopenic Purpura Responding to Combination Therapy With Eltrombopag and Rituximab

Ahmed

Yassin

Abdelmahmuod

2020

Cureus

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Idiopathic thrombocytopenic purpura (ITP) is a disease in which the immune system attacks platelets and decreases their number, which increases the patient's risk of bleeding. ITP is diagnosed by exclusion and usually manifests as acute disease. It is self-limiting in pediatric patients, while it tends to be a chronic disease in adults. Treatment of ITP focuses on maintaining a sufficient platelet count to decrease the risk of bleeding rather than normalize the platelet count. Most patients respond to first-line treatments, such as steroids and intravenous immunoglobulin (IVIG). However, some cases can become steroid-dependent or unresponsive to first-line therapy, in which case, second-line therapy is required to control symptoms or the platelet count. Second-line therapy includes either rituximab or a thrombopoietin receptor agonist (eltrombopag, romiplostim). In a few cases, when second-line therapy alone is insufficient to control the disease, a combination of therapies is required to control the symptoms and platelet count. Here, we present a case of a 41-year-old man with refractory ITP who did not respond to first-line treatment with either steroids or IVIG or a combination of the two, and also did not respond to eltrombopag alone and required a combination of eltrombopag and rituximab to control his disease.

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Low-Dose Eltrombopag in a Patient with Chronic Idiopathic Thrombocytopenic Purpura Post Sleeve Gastrectomy

Cited by 4 publications

References 4 publications

Eltrombopag Dose Adjustment During Infection-Induced Thrombocytosis in a Patient With Chronic Idiopathic Thrombocytopenic Purpura

Eltrombopag Dose Adjustment During Infection-Induced Thrombocytosis in a Patient With Chronic Idiopathic Thrombocytopenic Purpura

Eltrombopag and its beneficial role in management of ulcerative Colitis associated with ITP as an upfront therapy case report

Steroid-Refractory Chronic Idiopathic Thrombocytopenic Purpura Responding to Combination Therapy With Eltrombopag and Rituximab

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