Efficacy of Lusutrombopag for Thrombocytopenia in Patients with Chronic Liver Disease Scheduled to Undergo Invasive Procedures

被引：2

作者：

Nishida, Yuno ^{[1
]}

Kawaoka, Tomokazu ^{[1
]}

Imamura, Michio ^{[1
]}

Namba, Maiko ^{[1
]}

Fujii, Yasutoshi ^{[1
]}

Uchikawa, Shinsuke ^{[1
]}

Ohya, Kazuki ^{[1
]}

Daijo, Kana ^{[1
]}

Teraoka, Yuji ^{[1
]}

Morio, Kei ^{[1
]}

Fujino, Hatsue ^{[1
]}

Nakahara, Takashi ^{[1
]}

Yamauchi, Masami ^{[1
]}

Hiramatsu, Akira ^{[1
]}

Tsuge, Masataka ^{[1
]}

Aikata, Hiroshi ^{[1
]}

Takahashi, Shoichi ^{[1
]}

Hayes, C. Nelson ^{[1
]}

Fukuhara, Takayuki ^{[2
,3
]}

Tsuji, Keiji ^{[2
,3
]}

Arataki, Keiko ^{[4
]}

Nagaoki, Yuko ^{[5
]}

Aisaka, Yasuyuki ^{[6
]}

Kamada, Koji ^{[7
]}

Kodama, Hideaki ^{[8
]}

Chayama, Kazuaki ^{[1
]}

机构：

[1] Hiroshima Univ, Dept Gastroenterol & Metab, Grad Sch Biomed & Hlth Sci, Hiroshima, Japan

[2] Hiroshima Red Cross Hosp, Dept Gastroenterol, Liver Ctr, Hiroshima, Japan

[3] Atom Bomb Survivors Hosp, Hiroshima, Japan

[4] Tsuchiya Gen Hosp, Dept Gastroenterol, Hiroshima, Japan

[5] Mazda Hosp, Dept Gastroenterol, Hiroshima, Japan

[6] JA Hiroshima Gen Hosp, Dept Gastroenterol, Hiroshima, Japan

[7] Shobara Red Cross Hosp, Dept Internal Med, Hiroshima, Japan

[8] Hiroshima Nishi Med Ctr, Dept Hepatol, Otake, Hiroshima, Japan

来源：

INTERNAL MEDICINE | 2021年 / 60卷 / 06期

关键词：

lusutrombopag; thrombocytopenia; thrombopoietin receptor agonist; chronic liver disease; diabetes mellitus; THROMBOPOIETIN; TRANSFUSION; MANAGEMENT;

D O I：

10.2169/internalmedicine.5930-20

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective Lusutrombopag is a thrombopoietin receptor agonist that improves thrombocytopenia in patients with chronic liver disease scheduled to undergo invasive procedures. However, information on the efficacy of repeated lusutrombopag treatment and factors associated with the treatment is scarce. We analyzed the efficacy of repeated lusutrombopag treatment and the factors associated with a response to lusutrombopag. Methods Thirty-nine patients with chronic liver disease who received lusutrombopag treatment before undergoing invasive procedures were enrolled in this retrospective study. Of the 39 patients, 10 received lusutrombopag treatment multiple times for a total of 53 regimens of lusutrombopag treatment. Changes in platelet counts, the effects of repeated lusutrombopag treatment, and factors associated with response to lusutrombopag were analyzed. Results The median platelet count increased significantly from 4.5x10(4)/mu L before lusutrombopag treatment to 7.2x10(4)/mu L before the invasive procedure (p<0.01), and patients undergoing 49 of the 53 (92%) treatment regimens succeeded in undergoing invasive procedures without needing platelet transfusions. In patients who received lusutrombopag treatment repeatedly, the median platelet count significantly increased following the second administration of lusutrombopag, and the effects of lusutrombopag were similar between the first and second administration. A multivariate analysis identified the absence of diabetes mellitus (odds ratio, 5.56 for presence; p=0.04) as a significant and independent predictor of a response to lusutrombopag. Conclusion Lusutrombopag treatment significantly increased platelet counts in patients with chronic liver disease, making it possible to receive invasive procedures. The treatment produced identical effects when it was repeated. The efficacy of lusutrombopag might be decreased in patients with diabetes mellitus.

引用

页码：829 / 837

页数：9

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