Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China
Background: Eltrombopag (ELT), a thrombopoietin receptor agonist (TPO-RA), has been approved for relapsed/refractory aplastic anemia (AA). However, data on avatrombopag (AVA), another TPO-RA, are limited, and the comparisons between the two TPO-RAs are lacking. Objectives: We aimed to compare the ef...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-09-01
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| Series: | Therapeutic Advances in Hematology |
| Online Access: | https://doi.org/10.1177/20406207231191310 |
| _version_ | 1797685382370820096 |
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| author | Zhuxin Zhang Qinglin Hu Chen Yang Miao Chen Bing Han |
| author_facet | Zhuxin Zhang Qinglin Hu Chen Yang Miao Chen Bing Han |
| author_sort | Zhuxin Zhang |
| collection | DOAJ |
| description | Background: Eltrombopag (ELT), a thrombopoietin receptor agonist (TPO-RA), has been approved for relapsed/refractory aplastic anemia (AA). However, data on avatrombopag (AVA), another TPO-RA, are limited, and the comparisons between the two TPO-RAs are lacking. Objectives: We aimed to compare the efficacy and safety between ELT and AVA in relapsed/refractory AA patients. Design: In this retrospective study, patients with relapsed/refractory AA who had been treated with ELT ( N = 45) or AVA ( N = 30) alone and had compatible baseline hematological parameters were compared. Methods: Data from patients diagnosed with acquired AA were retrospectively collected. All patients were refractory/relapsed to standard immunosuppressive therapy (IST) for at least 6 months before ELT or AVA. Patients had to be treated with ELT or AVA alone for at least 6 months before evaluation if they did not respond. Baseline characteristics, overall response (OR), complete response (CR), relapse, adverse events, and factors that may affect efficacy were analyzed. Results: Of the 75 patients enrolled, 45 received ELT and 30 received AVA. Patients with AVA had a higher percentage of abnormal liver or renal function than those with ELT ( p = 0.036). No significant difference was found in the OR/CR rate in the first/second/third/sixth month between the two cohorts ( p > 0.05). Patients treated with AVA had a shorter median time to response than those treated with ELT ( p = 0.012) and had a higher platelet level in the second month ( p = 0.041). AVA had fewer adverse events than ELT ( p = 0.046). Under compatible follow-up time ( p = 0.463), no difference was found between the ELT and AVA cohorts in relapse ( p = 1.000) or clone evolution ( p = 0.637). No predictive factors for OR and CR in the sixth month were found for either ELT or AVA. Conclusion: With worse liver or renal function, AVA had a similar OR/CR rate but a shorter median time to response and fewer adverse events for patients with relapsed/refractory AA. |
| first_indexed | 2024-03-12T00:43:22Z |
| format | Article |
| id | doaj.art-a0740bba112f42d8b51ccf767f6a5d0d |
| institution | Directory Open Access Journal |
| issn | 2040-6215 |
| language | English |
| last_indexed | 2024-03-12T00:43:22Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Hematology |
| spelling | doaj.art-a0740bba112f42d8b51ccf767f6a5d0d2023-09-15T01:03:34ZengSAGE PublishingTherapeutic Advances in Hematology2040-62152023-09-011410.1177/20406207231191310Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in ChinaZhuxin ZhangQinglin HuChen YangMiao ChenBing HanBackground: Eltrombopag (ELT), a thrombopoietin receptor agonist (TPO-RA), has been approved for relapsed/refractory aplastic anemia (AA). However, data on avatrombopag (AVA), another TPO-RA, are limited, and the comparisons between the two TPO-RAs are lacking. Objectives: We aimed to compare the efficacy and safety between ELT and AVA in relapsed/refractory AA patients. Design: In this retrospective study, patients with relapsed/refractory AA who had been treated with ELT ( N = 45) or AVA ( N = 30) alone and had compatible baseline hematological parameters were compared. Methods: Data from patients diagnosed with acquired AA were retrospectively collected. All patients were refractory/relapsed to standard immunosuppressive therapy (IST) for at least 6 months before ELT or AVA. Patients had to be treated with ELT or AVA alone for at least 6 months before evaluation if they did not respond. Baseline characteristics, overall response (OR), complete response (CR), relapse, adverse events, and factors that may affect efficacy were analyzed. Results: Of the 75 patients enrolled, 45 received ELT and 30 received AVA. Patients with AVA had a higher percentage of abnormal liver or renal function than those with ELT ( p = 0.036). No significant difference was found in the OR/CR rate in the first/second/third/sixth month between the two cohorts ( p > 0.05). Patients treated with AVA had a shorter median time to response than those treated with ELT ( p = 0.012) and had a higher platelet level in the second month ( p = 0.041). AVA had fewer adverse events than ELT ( p = 0.046). Under compatible follow-up time ( p = 0.463), no difference was found between the ELT and AVA cohorts in relapse ( p = 1.000) or clone evolution ( p = 0.637). No predictive factors for OR and CR in the sixth month were found for either ELT or AVA. Conclusion: With worse liver or renal function, AVA had a similar OR/CR rate but a shorter median time to response and fewer adverse events for patients with relapsed/refractory AA.https://doi.org/10.1177/20406207231191310 |
| spellingShingle | Zhuxin Zhang Qinglin Hu Chen Yang Miao Chen Bing Han Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China Therapeutic Advances in Hematology |
| title | Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China |
| title_full | Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China |
| title_fullStr | Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China |
| title_full_unstemmed | Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China |
| title_short | Comparison of eltrombopag and avatrombopag in the treatment of refractory/relapsed aplastic anemia: a single-center retrospective study in China |
| title_sort | comparison of eltrombopag and avatrombopag in the treatment of refractory relapsed aplastic anemia a single center retrospective study in china |
| url | https://doi.org/10.1177/20406207231191310 |
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