Treatment patterns and clinical outcomes in patients with chronic immune thrombocytopenia (ITP) switched to eltrombopag or romiplostim

Abstract

This observational study aimed to assess real-world treatment patterns and clinical outcomes for patients with chronic immune thrombocytopenia (ITP) currently being treated with eltrombopag or romiplostim after switching from corticosteroids, rituximab, or the alternate thrombopoietin receptor agonist (TPO-RA). The study examined the rationale for switching to TPO-RA therapy using aided responses. Dosing patterns were also analyzed before and after switching. Treatment outcomes were assessed through platelet counts at multiple time points including treatment initiation and after switching at the last office visit. A total of 280 patients were enrolled whose active therapy for ITP was replaced with either eltrombopag (n = 130) or romiplostim (n = 150). Efficacy-related issues (desired platelet count not achieved and/or lack of response to prior therapy) were the main drivers for therapy switching among all patients (54 % for eltrombopag vs. 57 % for romiplostim). Platelet counts at the last office visit showed improvement compared with counts at the initiation of either eltrombopag or romiplostim treatment. No significant differences were noted when comparing clinical outcomes between the eltrombopag and romiplostim treatment cohorts. Our results suggest that switching to the other TPO-RA may be beneficial if there is inadequate response to treatment with the initial TPO-RA.

Thrombopoietin Receptor Agonists Are Often Ineffective in Immune Thrombocytopenia and/or Cause Adverse Reactions: Results from One Hand

“…As observed in our and in other studies [21,22,23,24], switching between TPOs appears to be beneficial in regard to efficacy and adverse reactions; nevertheless, some patients remained refractory to both drugs (5 of 25 patients). Furthermore, adverse reactions cannot invariably be overcome by switching.…”

Thrombopoietin Receptor Agonists in Treatment of Idiopathic Thrompocytopenic Purpura (Primary Immune Thrombocytopenia): Efficacy and Safety in Everyday Clinical Practice

“…В качестве следующей линии терапии 3 из них была выполнена СЭ. Полученные данные по резистентности к проводимой терапии сопоставимы как с результатами многоцентровых рандомизированных исследований [14,15], так и с ис-следованиями отдельных центров [6,19,20,22].…”

“…При анализе зарубежных и отечественных публикаций ре-зультаты терапии в целом, а также данные по исполь-зованию ромиплостима и элтромбопага различаются [6,[19][20][21][22].…”

Thrombopoietin receptor agonist switch in children with persistent and chronic severe immune thrombocytopenia: A retrospective analysis in a large tertiary center

“…Several reports describing successful switches TPORAs in adults have been published . However, experience with switching TPORA in children with ITP is scarce.…”

“…10 Several reports describing successful switches TPORAs in adults have been published. [11][12][13][14] However, experience with switching TPORA Abbreviations: ITP, immune thrombocytopenia; IVIG, intravenous immune globulin; TPORA, thrombopoietin receptor agonist. in children with ITP is scarce.…”