Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia
Primary immune thrombocytopenia (ITP) is a bleeding disorder that conventionally has been treated with steroids or other immunosuppressive treatments. The introduction of thrombopoietin receptor agonists (TPO-RAs), which increase platelet production, dramatically changed the treatment landscape for...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-03-01
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| Series: | Therapeutic Advances in Hematology |
| Online Access: | https://doi.org/10.1177/2040620719837906 |
| _version_ | 1819205208117346304 |
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| author | José R. González-Porras Bertrand Godeau Monica Carpenedo |
| author_facet | José R. González-Porras Bertrand Godeau Monica Carpenedo |
| author_sort | José R. González-Porras |
| collection | DOAJ |
| description | Primary immune thrombocytopenia (ITP) is a bleeding disorder that conventionally has been treated with steroids or other immunosuppressive treatments. The introduction of thrombopoietin receptor agonists (TPO-RAs), which increase platelet production, dramatically changed the treatment landscape for ITP by providing patients with well-tolerated, long-term treatment options. Two TPO-RAs, eltrombopag and romiplostim, have been approved in the United States and European Union for the treatment of ITP. Some patients do not benefit from the first TPO-RA they receive, so it is assumed that the alternate TPO-RA would have the same outcome. However, eltrombopag and romiplostim have distinct pharmacodynamic and pharmacokinetic properties and may have different tolerability and efficacy in individual patients with ITP. Published retrospective studies showed that >75% of patients who switched to the alternate TPO-RA maintained or achieved a response with the new treatment. Notably, most patients who switched due to lack of efficacy with the first TPO-RA responded to the alternate TPO-RA, which demonstrates an absence of cross-resistance between the two drugs. Therefore, switching to the alternate TPO-RA if the first TPO-RA fails to demonstrate a response should be considered before the use of a less-preferable option. |
| first_indexed | 2024-12-23T04:48:03Z |
| format | Article |
| id | doaj.art-1372ea70a7f34572a1b9e85439dc6963 |
| institution | Directory Open Access Journal |
| issn | 2040-6215 |
| language | English |
| last_indexed | 2024-12-23T04:48:03Z |
| publishDate | 2019-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Hematology |
| spelling | doaj.art-1372ea70a7f34572a1b9e85439dc69632022-12-21T17:59:33ZengSAGE PublishingTherapeutic Advances in Hematology2040-62152019-03-011010.1177/2040620719837906Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopeniaJosé R. González-PorrasBertrand GodeauMonica CarpenedoPrimary immune thrombocytopenia (ITP) is a bleeding disorder that conventionally has been treated with steroids or other immunosuppressive treatments. The introduction of thrombopoietin receptor agonists (TPO-RAs), which increase platelet production, dramatically changed the treatment landscape for ITP by providing patients with well-tolerated, long-term treatment options. Two TPO-RAs, eltrombopag and romiplostim, have been approved in the United States and European Union for the treatment of ITP. Some patients do not benefit from the first TPO-RA they receive, so it is assumed that the alternate TPO-RA would have the same outcome. However, eltrombopag and romiplostim have distinct pharmacodynamic and pharmacokinetic properties and may have different tolerability and efficacy in individual patients with ITP. Published retrospective studies showed that >75% of patients who switched to the alternate TPO-RA maintained or achieved a response with the new treatment. Notably, most patients who switched due to lack of efficacy with the first TPO-RA responded to the alternate TPO-RA, which demonstrates an absence of cross-resistance between the two drugs. Therefore, switching to the alternate TPO-RA if the first TPO-RA fails to demonstrate a response should be considered before the use of a less-preferable option.https://doi.org/10.1177/2040620719837906 |
| spellingShingle | José R. González-Porras Bertrand Godeau Monica Carpenedo Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia Therapeutic Advances in Hematology |
| title | Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| title_full | Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| title_fullStr | Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| title_full_unstemmed | Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| title_short | Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| title_sort | switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia |
| url | https://doi.org/10.1177/2040620719837906 |
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