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Discontinuation of eltrombopag deemed safe after complete remission of primary ITP
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The discontinuation of eltrombopag appeared safe in patients in complete remission of primary immune thrombocytopenia, according to study results.
Tomás José González-López, MD, PhD, of the department of hematology at the Hospital Universitario de Burgos in Spain, and colleagues evaluated data from 260 adults (mean age, 62 years) with primary immune thrombocytopenia (ITP). The cohort included 165 women and 95 men treated with eltrombopag (Promacta, GlaxoSmithKline) for an average of 24 months after ITP diagnosis.
Researchers reported complete remissions in 201 patients; of these patients, 80 discontinued treatment with eltrombopag.
Thirty-three patients discontinued eltrombopag because they demonstrated persistent response even with a reduction in dose. Twenty-nine patients discontinued treatment because they achieved a platelet count >400/L x 109/L. Other reasons for discontinuation were patient response (n=5), elevated aspartate aminotransferase levels (n=3), diarrhea (n=3) and thrombosis (n=3). Four patients discontinued due to other reasons.
Forty-nine patients were valuable after eltrombopag discontinuation. At a mean follow-up of 9 months post-discontinuation, 26 (mean age, 59 years; 15 female) of these patients achieved a sustained response with no additional ITP therapy. In this subset, the average time since ITP diagnosis was 46.5 months, and four of the 26 had ITP for less than 1 year. These patients received a mean of four previous treatment lines, and 42% were splenectomized.
“No predictive factors of sustained response after eltrombopag withdrawal were identified,” the researchers wrote. “Platelet response following eltrombopag cessation may be sustained in an important percentage of adult primary ITP patients who achieved complete response with eltrombopag. However, reliable markers for predicting which patients will have this response are needed.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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