Dynamic dosing of romiplostim in patients with immune thrombocytopenia purpura: Two case reports

被引:1
作者
Gilreath, Jeffrey A. [1 ,2 ]
Wei, Mei [3 ]
Paul, Shilpa [4 ]
Parker, Charles J. [3 ]
Stenehjem, David D. [2 ,5 ]
Rodgers, George M. [3 ]
机构
[1] Univ Utah, Huntsman Canc Inst, 1950 Circle Hope, Salt Lake City, UT 84112 USA
[2] Univ Utah, Dept Pharmacotherapy, Salt Lake City, UT USA
[3] Univ Utah, Dept Internal Med, Salt Lake City, UT 84112 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Clin Pharm Serv, Houston, TX 77030 USA
[5] Univ Minnesota, Dept Pharm Practice & Pharmaceut Sci, Duluth, MN 55812 USA
关键词
Immune thrombocytopenic purpura; romiplostim; benign hematology; thrombopoietin receptor agonist; THROMBOPOIETIN; RECEPTOR; EFFICACY; AMG-531; GROWTH;
D O I
10.1177/1078155217752536
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Romiplostim is a thrombopoietin receptor agonist approved for the treatment of immune thrombocytopenia purpura. When following FDA-approved romiplostim prescribing recommendations to withhold treatment for platelet counts above 400k/mu L, some patients exhibit a precipitous decline in their platelet count potentially causing patient harm. We present two cases where stable platelet counts were achieved only through persistent weekly dosing of romiplostim despite platelet counts above 400k/mu L on the day of administration. Therefore, continuous weekly dosing of romiplostim despite platelet count being above 400k/mu L combined with twice weekly vigilant monitoring is an alternative method of romiplostim dosing that mitigates severe fluctuations in platelets. We also discuss important details, postulated mechanisms, and evidence-based mitigation strategies.
引用
收藏
页码:719 / 723
页数:5
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