A Review of Romiplostim Mechanism of Action and Clinical Applicability
| Autor: | Adriana Balduzzi, Gerald A. Soff, James B. Bussel, Tatiana Lawrence, Nichola Cooper, John W. Semple |
|---|---|
| Přispěvatelé: | Bussel, J, Soff, G, Balduzzi, A, Cooper, N, Lawrence, T, Semple, J |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Recombinant Fusion Proteins Pharmacokinetic Pharmaceutical Science Review Receptors Fc thrombopoietin receptor agonist 03 medical and health sciences 0302 clinical medicine Megakaryocyte Internal medicine hemic and lymphatic diseases Drug Discovery medicine pharmacodynamics media_common.cataloged_instance Humans structure European union Aplastic anemia Thrombopoietin media_common Pharmacology Chemotherapy Clinical Trials as Topic Purpura Thrombocytopenic Idiopathic Pharmacodynamic Hematology Romiplostim business.industry medicine.disease 030104 developmental biology medicine.anatomical_structure immune thrombocytopenia 030220 oncology & carcinogenesis Immunology Bone marrow business pharmacokinetics medicine.drug |
| Zdroj: | Drug Design, Development and Therapy |
| ISSN: | 1177-8881 |
| Popis: | Thrombocytopenia results from a variety of conditions, including radiation, chemotherapy, autoimmune disease, bone marrow disorders, pathologic conditions associated with surgical procedures, hematopoietic stem cell transplant (HSCT), and hematologic disorders associated with severe aplastic anemia. Immune thrombocytopenia (ITP) is caused by immune reactions that accelerate destruction and reduce production of platelets. Thrombopoietin (TPO) is a critical component of platelet production pathways, and TPO receptor agonists (TPO-RAs) are important for the management of ITP by increasing platelet production and reducing the need for other treatments. Romiplostim is a TPO-RA approved for use in patients with ITP in the United States, European Union, Australia, and several countries in Africa and Asia, as well as for use in patients with refractory aplastic anemia in Japan and Korea. Romiplostim binds to and activates the TPO receptor on megakaryocyte precursors, thus promoting cell proliferation and viability, resulting in increased platelet production. Through this mechanism, romiplostim reduces the need for other treatments and decreases bleeding events in patients with thrombocytopenia. In addition to its efficacy in ITP, studies have shown that romiplostim is effective in improving platelet counts in various settings, thereby highlighting the versatility of romiplostim. The efficacy of romiplostim in such disorders is currently under investigation. Here, we review the structure, mechanism, pharmacokinetics, and pharmacodynamics of romiplostim. We also summarize the clinical evidence supporting its use in ITP and other disorders that involve thrombocytopenia, including chemotherapy-induced thrombocytopenia, aplastic anemia, acute radiation syndrome, perisurgical thrombocytopenia, post-HSCT thrombocytopenia, and liver disease. |
| Databáze: | OpenAIRE |
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