New Drug Raises Platelet Counts in ITP and Cirrhosis
Eltrombopag appears to be well tolerated, more research needed
WEDNESDAY, Nov. 28 (HealthDay News) -- Eltrombopag, an oral thrombopoietin-receptor agonist that stimulates platelet production, may be useful in raising low platelet counts associated with idiopathic thrombocytopenic purpura (ITP) and hepatitis C virus (HCV)-related cirrhosis, according to two articles published in the Nov. 29 issue of the New England Journal of Medicine.
James B. Bussel, M.D., of Weill Cornell Medical College of Cornell University in New York City, and colleagues randomized 118 patients with chronic refractory or relapsed ITP and platelet counts less than 30,000 per cubic millimeter to receive either eltrombopag (30, 50, or 75 mg daily) or placebo. The researchers found that eltrombopag increased platelet counts in a dose-dependent manner, while rates and severity of adverse events did not differ from placebo.
In a second study, John G. McHutchinson, M.D., of Duke University in Durham, N.C., and colleagues randomized 74 patients with HCV-related cirrhosis and platelet counts between 20,000 to 70,000 per cubic millimeter to receive either eltrombopag (30, 50, or 75 mg daily) or placebo for a total of 16 weeks, with antiviral therapy begun at week 4 if possible. Eltrombopag increased platelet counts in a dose-dependent manner, permitting the initiation of antiviral therapy in the majority of eltrombopag-treated patients.
"The results reported for thrombopoietin-receptor agonists are too preliminary for any definitive statement about applications in clinical practice, but they surely encourage further work in this direction," writes Robert S. Schwartz, M.D., in an accompanying editorial.