Effect of three or more treatments with lusutrombopag in patients with cirrhotic thrombocytopenia: A retrospective single-center study.

Abstract

AIMS:

Thrombocytopenia is a common complication among patients with chronic liver disease (CLD). Lusutrombopag, an oral thrombopoietin receptor agonist, is used to reduce the risk of hemorrhage in patients with thrombocytopenia who are undergoing invasive procedures. Platelet transfusion was the standard treatment for thrombocytopenia; however, multiple platelet transfusions lead to the production of antiplatelet antibody. The effect of giving lusutrombopag three times or more has not been previously reported. In this study, we investigated the effect of lusutrombopag readministration in patients with thrombocytopenia.

METHODS:

This study included 14 patients (total, 24 readministrations) who received lusutrombopag two times or more. Changes in platelet counts were evaluated. Treatment response was defined as an increased platelet count of ≥20 000/μL after lusutrombopag treatment.

RESULTS:

Lusutrombopag was given twice in nine patients, three times in three patients, five times in one patient, and six times in one patient. An elevated platelet count of <20 000/μL was noted in only one of the 24 readministrations. There were no postoperative hemorrhagic complications, and no patient had an increased platelet count of >200 000/μL. One patient had a portal venous mural thrombus; however, he was asymptomatic, and the thrombus resolved after anticoagulant treatment, without recurrence. The comparison between the first, second, and third or more treatments showed there was no significant difference in platelet increase.

CONCLUSION:

Repeated treatment of lusutrombopag is effective for CLD patients with thrombocytopenia. Moreover, three or more treatments with lusutrombopag showed equal effect compared with one and two treatments with the medication.

• Authors: Hideto Kawaratani, Yuki Tsuji, Koji Ishida, Daisuke Kaya, Takuya Kubo, Yukihisa Fujinaga, Yasuhiko Sawada, Shinya Sato, Hiroaki Takaya, Kosuke Kaji, Tadashi Namisaki, Kei Moriya, Takemi Akahane, Hitoshi Yoshiji
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 50 Issue 9 Pg. 1101-1105 (Sep 2020) ISSN: 1386-6346 [Print] Netherlands
• PMID: 32558192 (Publication Type: Journal Article)
• Copyright: © 2020 The Japan Society of Hepatology.