典型文献
Switching between eltrombopag and recombinant human thrombopoietin in patients with immune thrombocytopenia: an observational study
文献摘要：
Background::Recombinant human thrombopoietin (rh-TPO) and eltrombopag are two distinct TPO receptor agonists (TPO-RAs) with different mechanisms. During the pandemic, when immunosuppressive medications are controversial, switching to another TPO-RA may be worth exploring in patients who do not benefit from their first TPO-RA. We investigated the outcomes of switching from rh-TPO to eltrombopag or vice versa in immune thrombocytopenia (ITP) patients.Methods::This prospective, open-label, observational investigation included 96 adult ITP patients who needed to switch between rh-TPO and eltrombopag between January 2020 and January 2021 at Peking University People’s Hospital in China. The study evaluated response rates and platelet counts at different time points after the switch, bleeding events, time to response, duration of response, and adverse events.Results::At 6 weeks after switching, response was observed in 21/49 patients (43%) who switched for inefficacy and 34/47 patients (72%) who switched for non-efficacy-related issues. In the inefficacy group, 9/27 patients (33%) responded to eltrombopag, and 12/22 patients (55%) responded to rh-TPO. In the non-efficacy-related group, 21/26 (81%) and 13/21 (62%) patients in the eltrombopag and rh-TPO groups maintained their response rates at 6 weeks after switching, respectively. Response at 6 months was achieved in 24/49 patients (49%) switching for inefficacy and 37/47 patients (79%) switching for non-efficacy issues. In the inefficacy group, 13/27 patients (48%) responded to eltrombopag, and 11/22 patients (50%) responded to rh-TPO. In the non-efficacy-related group, 22/26 patients (85%) and 15/21 patients (71%) in the eltrombopag and rh-TPO groups maintained their response rates at 6 months after switching, respectively. Both eltrombopag and rh-TPO were well tolerated.Conclusions::Our study confirmed the safety and effectiveness of switching between rh-TPO and eltrombopag for ITP patients who had no response to or experienced adverse events with their first TPO-RA. When the switch was motivated by other reasons, including patient preference and platelet count fluctuations, the probability of response was high.Registration::ClinicalTrials.gov, NCT04214951.
文献关键词：
Immune thrombocytopenia;Treatment switching;Treatment outcome;Eltrombopag;Thrombopoietin
中图分类号：
作者姓名：
Cai Xuan;Fu Haixia;Zhao Xiangyu;Lu Jin;Jiang Qian;Chang Yingjun;Huang Xiaojun;Zhang Xiaohui
作者机构：
Department of Hematology, Peking University People’s Hospital, Beijing 100044, China;Peking University Institute of Hematology, Beijing 100044, China;National Clinical Research Center for Hematologic Disease, Beijing 100044, China;Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
文献出处：
引用格式：
[1]Cai Xuan;Fu Haixia;Zhao Xiangyu;Lu Jin;Jiang Qian;Chang Yingjun;Huang Xiaojun;Zhang Xiaohui-.Switching between eltrombopag and recombinant human thrombopoietin in patients with immune thrombocytopenia: an observational study)[J].中华医学杂志（英文版）,2022(19):2344-2350
A类：
eltrombopag,inefficacy,NCT04214951,Eltrombopag,Thrombopoietin
B类：
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AB值：
0.367361
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