Outcomes of switching to avatrombopag following treatment failure with eltrombopag in paediatric immune thrombocytopenia: A real-world study in China

被引:12
作者
Cheng, Xiaoling [1 ]
Wang, Zhifa [2 ]
Dong, Shuyue [2 ]
Ma, Jingyao [2 ]
Meng, Jinxi [2 ]
Wang, Xiaoling [1 ]
Wu, Runhui [2 ,3 ]
机构
[1] Capital Med Univ, Beijing Childrens Hosp, Dept Pharm, Beijing, Peoples R China
[2] Capital Med Univ, Beijing Childrens Hosp, Hematol Oncol Ctr, Beijing, Peoples R China
[3] Capital Med Univ, Beijing Childrens Hosp, Hematol Oncol Ctr, 56 Nanlishi Rd, Beijing, Peoples R China
基金
北京市自然科学基金; 中国国家自然科学基金;
关键词
avatrombopag; children; eltrombopag; immune thrombocytopenia; switch; RETROSPECTIVE COLLABORATIVE SURVEY; THROMBOPOIETIN RECEPTOR AGONISTS; TREATMENT PATTERNS; CHILDREN; ADULTS; CONSENSUS; ITP;
D O I
10.1111/bjh.18864
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder characterized by isolated thrombocytopenia and a haemorrhagic risk. Thrombopoietin receptor agonists (TPO-RAs) are highly effective for ITP and are widely used to treat patients with steroid treatment failure or dependency. However, although treatment response to TPO-RAs may differ according to the type, the potential impact of switching from eltrombopag (ELT) to avatrombopag (AVA) with respect to efficacy or tolerance in children remains unknown. This study aimed to evaluate the outcomes of switching from ELT to AVA in paediatric patients with ITP. We retrospectively evaluated children with chronic immune thrombocytopenia (cITP) switched from ELT to AVA owing to treatment failure at the Hematology-Oncology Center of Beijing Children's Hospital between July 2021 and May 2022. Overall, 11 children (seven and four boys and girls respectively) with a median age of 8.3 (range: 3.8-15.3) years were included. The overall response and complete response (platelet [PLT] count =100 x 10(9)/L) rates during AVA treatment were 81.8% (9/11) and 54.6% (6/11) respectively. The median PLT count was significantly increased from ELT to AVA (7 [range: 2-33] x 10(9)/L vs. 74 [15-387] x 10(9)/L; p = 0.007). The median time to PLT count =30 x 10(9)/L was 18 (range: 3-120) days. Overall, 7/11 patients (63.6%) used concomitant medications, and concomitant medication use was gradually discontinued within 3-6 months after AVA initiation. In conclusion, AVA after ELT is effective in the heavily pretreated paediatric cITP population, with high response rates even in those with an inadequate response to a prior TPO-RA.
引用
收藏
页码:636 / 644
页数:9
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