Real-life experience with avatrombopag

Dhruv Verma, J. Yum, Kyra LeRoy, T. McDaniel, S. Saab
{"title":"Real-life experience with avatrombopag","authors":"Dhruv Verma, J. Yum, Kyra LeRoy, T. McDaniel, S. Saab","doi":"10.21037/DMR-21-10","DOIUrl":null,"url":null,"abstract":"Background: Platelet transfusion is the standard of care for managing thrombocytopenia in patients with advanced liver disease undergoing procedures. Randomized control trials have demonstrated the safety and efficacy of avatrombopag in the management of thrombocytopenia in this population. However, real-world data is limited. Methods: Retrospective cohort study performed in patients 18 and older with thrombocytopenia and liver disease who were prescribed avatrombopag before invasive procedure. Patients were stratified by platelet count into high (>40.0×10 9 /L) and low baseline (<40.0×10 9 /L) cohorts. Demographic, clinical data, changes in platelet count, use of platelet transfusion, rescue therapy, and incidence of portal vein thrombosis were recorded. Results: Of the 29 study patients, 59% were male and the mean age was 62 years. Hepatitis C virus infection was the most common etiology of liver disease (28%) and esophagogastroduodenoscopy was the most common procedure performed (86%). Mean baseline platelet count was 39.3×10 9 /L and 16 patients had platelet counts below 40.0×10 9 /L. Platelet count increased 2.2 folds, from 37.4×10 9 /L to 76.9×10 9 /L in 20 patients who had peri-procedure platelet counts. No patients required rescue therapy or platelet transfusion and there were no adverse effects. There was no new portal vein thrombosis. Conclusions: Results from this real-world study are consistent with the results of the clinical trials for avatrombopag. Avatrombopag is a safe and effective alternative to platelet transfusion to treat thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure. Our primary outcome assessed efficacy as defined as the proportion of patients who did not require a platelet transfusion or rescue procedure for bleeding up to 7 days after a procedure. Secondary end points assessed adverse events as defined as the proportion of patients with adverse events and proportion of patients who developed portal vein thrombosis after receiving avatrombopag. Sensitivity analysis was performed on platelet response to avatrombopag.","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive medicine research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21037/DMR-21-10","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3

Abstract

Background: Platelet transfusion is the standard of care for managing thrombocytopenia in patients with advanced liver disease undergoing procedures. Randomized control trials have demonstrated the safety and efficacy of avatrombopag in the management of thrombocytopenia in this population. However, real-world data is limited. Methods: Retrospective cohort study performed in patients 18 and older with thrombocytopenia and liver disease who were prescribed avatrombopag before invasive procedure. Patients were stratified by platelet count into high (>40.0×10 9 /L) and low baseline (<40.0×10 9 /L) cohorts. Demographic, clinical data, changes in platelet count, use of platelet transfusion, rescue therapy, and incidence of portal vein thrombosis were recorded. Results: Of the 29 study patients, 59% were male and the mean age was 62 years. Hepatitis C virus infection was the most common etiology of liver disease (28%) and esophagogastroduodenoscopy was the most common procedure performed (86%). Mean baseline platelet count was 39.3×10 9 /L and 16 patients had platelet counts below 40.0×10 9 /L. Platelet count increased 2.2 folds, from 37.4×10 9 /L to 76.9×10 9 /L in 20 patients who had peri-procedure platelet counts. No patients required rescue therapy or platelet transfusion and there were no adverse effects. There was no new portal vein thrombosis. Conclusions: Results from this real-world study are consistent with the results of the clinical trials for avatrombopag. Avatrombopag is a safe and effective alternative to platelet transfusion to treat thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure. Our primary outcome assessed efficacy as defined as the proportion of patients who did not require a platelet transfusion or rescue procedure for bleeding up to 7 days after a procedure. Secondary end points assessed adverse events as defined as the proportion of patients with adverse events and proportion of patients who developed portal vein thrombosis after receiving avatrombopag. Sensitivity analysis was performed on platelet response to avatrombopag.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
avatrombopag的真实体验
背景:血小板输注是治疗晚期肝病患者血小板减少症的标准护理。随机对照试验已经证明了阿伏罗巴格治疗这类人群血小板减少症的安全性和有效性。然而,真实世界的数据是有限的。方法:回顾性队列研究对18岁及以上伴有血小板减少症和肝脏疾病的患者进行了回顾性队列研究,这些患者在侵入性手术前服用了阿伐波帕。根据血小板计数将患者分层为高(>40.0×10 9 /L)和低基线(<40.0×10 9 /L)队列。记录患者的人口统计学、临床资料、血小板计数变化、血小板输注使用、抢救治疗及门静脉血栓发生率。结果:29例患者中,59%为男性,平均年龄62岁。丙型肝炎病毒感染是肝脏疾病最常见的病因(28%),食管胃十二指肠镜检查是最常见的手术(86%)。平均基线血小板计数为39.3×10 9 /L, 16例患者血小板计数低于40.0×10 9 /L。在20例术中有血小板计数的患者中,血小板计数增加2.2倍,从37.4×10 9 /L增加到76.9×10 9 /L。无患者需要抢救治疗或输血小板,无不良反应。无新的门静脉血栓形成。结论:这项真实世界研究的结果与阿伏罗巴格临床试验的结果一致。对于计划接受手术的慢性肝病患者,Avatrombopag是一种安全有效的替代血小板输注治疗血小板减少症的方法。我们的主要结局评估的疗效定义为手术后7天内不需要血小板输注或抢救手术的患者比例。次要终点评估不良事件,定义为不良事件患者的比例和服用阿伐罗巴格后发生门静脉血栓患者的比例。对血小板对阿伐波帕的反应进行敏感性分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
0.10
自引率
0.00%
发文量
0
期刊最新文献
Histone acylations as a mechanism for regulation of intestinal epithelial cells. Focus on technical advancement in mini-invasive hepatobiliary Liver gates to access everywhere in the liver: how can we learn? Advances in the management of peritoneal carcinomatosis Ablative radiation therapy advances in pancreatic cancer
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1