Deciphering predictive factors for choice of thrombopoietin receptor agonist, treatment free responses, and thrombotic events in immune thrombocytopenia.

Autor: Lozano ML; Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain. mllozano@um.es., Mingot-Castellano ME; Hospital Carlos Haya, Málaga; Hospital Universitario Virgen del Rocio, Sevilla, Spain., Perera MM; Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain., Jarque I; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Campos-Alvarez RM; Hospital de Especialidades de Jerez de la Frontera, Cádiz, Spain., González-López TJ; Hospital Universitario de Burgos, Burgos, Spain., Carreño-Tarragona G; Hospital 12 de Octubre, Madrid, Spain., Bermejo N; Hospital San Pedro de Alcántara, Cáceres, Spain., Lopez-Fernandez MF; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain., de Andrés A; Complexo Hospitalario Universitario de Santiago, A Coruña, Spain., Valcarcel D; Vall d'Hebron Institute of Oncology (VHIO), University Hospital Vall d'Hebron, Barcelona, Spain., Casado-Montero LF; Hospital Virgen de la Salud, Toledo, Spain., Alvarez-Roman MT; Hospital Universitario La Paz-Idipaz, Madrid, Spain., Orts MI; Hospital de Sagunto, Valencia, Spain., Novelli S; Hospital Sant Creu i Sant Pau, Barcelona, Spain., Revilla N; Hospital Universitario Morales Meseguer, Murcia, Spain., González-Porras JR; Hospital Universitario de Salamanca (HUSAL/IBSAL), and IBMCC (USAL-CSIC), Salamanca, Spain., Bolaños E; Hospital Clínico San Carlos, Madrid, Spain., Rodríguez-López MA; Hospital Álvaro Cunqueiro, Pontevedra, Spain., Orna-Montero E; Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain., Vicente V; Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2019 Nov 13; Vol. 9 (1), pp. 16680. Date of Electronic Publication: 2019 Nov 13.
DOI: 10.1038/s41598-019-53209-y
Abstrakt: Very few data exist on when a particular thrombopoietin-receptor agonist (TPO-RA) is favored in clinical practice for the treatment of patients with immune thrombocytopenia (ITP), about novel risk factors for vascular events (VE) with these drugs, nor about predictive factors for therapy free responses (TFR). We conducted an observational, retrospective, long-term follow-up multicenter study from November 2016 to January 2018 of 121 adult ITP patients initiating TPO-RA between January 2012 to December 2014. Data reflected that a platelet count ≤25 × 10 9 /l at the time when the TPO-RA was initiated was associated with a 2.8 higher probability of receiving romiplostim vs. eltrombopag (P = 0.010). VE on TPO-RA was related to previous neoplasia in patients over 65 years (50% vs. 2.2%, P < 0.001), and to previous splenectomy in younger patients (100% vs. 33%, P = 0.001). Receiving romiplostim as first TPO-RA with no subsequent TPO-RA switching was associated with a 50% likelihood of TFR after 2.9 years of therapy (3.3 years in chronic ITP patients). These real-world data help deciphering some areas of uncertainty, and offer insight into some of the most relevant challenges of ITP which may help clinicians make appropriate treatment decisions in the management of adult ITP patients with TPO-RA.
Databáze: MEDLINE
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