Key result
Lusutrombopag is linked to avoiding platelet transfusions in ~73% of chronic liver disease patients.
Why the study?
There is limited information on the efficacy and safety of lusutrombopag in chronic liver disease patients with severe thrombocytopenia in real-world settings.
Does lusutrombopag improve platelet counts and prevent the need for platelet transfusion in patients with chronic liver disease and severe thrombocytopenia?
Cohort (n=26)
Yes
Does lusutrombopag improve platelet counts and prevent the need for platelet transfusion in patients with chronic liver disease and severe thrombocytopenia?
Lusutrombopag effectively and safely increases platelet counts in patients with chronic liver disease and severe thrombocytopenia, reducing the need for platelet transfusions before invasive procedures.
May support avoiding transfusions before procedures in chronic liver disease; hypothesis-generating pending randomized confirmation.
Background: Chronic liver disease (CLD) is often complicated by severe thrombocytopenia (platelet count <50,000/µL). Platelet transfusion has been a gold standard for increasing the platelet count to prevent hemorrhagic events in such patients. Lusutrombopag, a thrombopoietin receptor agonist, can increase the platelet count in such patients when invasive procedures are scheduled. However, we have little information on the effect of lusutrombopag in CLD patients with severe thrombocytopenia in real-world settings.Methods: To investigate the efficacy and safety of lusutrombopag in patients with chronic liver disease and severe thrombocytopenia, we retrospectively investigated 26 CLD patients with a platelet count of <50,000/µL. Lusutrombopag, 3 mg once daily, was administered 8-15 days before scheduled invasive procedures.Results: Among 26 patients who received lusutrombopag, 19 patients (73.1%) patients showed a platelet count of ≥50,000/µL (Group A) and did not require platelet transfusion. The remaining 7 patients (26.9%) did not reached platelet ≥50,000/µL (Group B). The means of platelet increase were 36,000/µL and 13,000/µL in groups A and B, respectively. A low platelet count at baseline was a characteristic of patients in group B. Among 13 patients who repeatedly used lusutrombopag, lusutrombopag significantly increased the platelet count as the initial treatment. No adverse events were noted during or after lusutrombopag treatment. In addition, the degree of platelet increase with lusutrombopag was larger than that in their previous platelet transfusion.Conclusions: Lusutrombopag is effective and safe for CLD patients with a platelet count of <50,000/µL.
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Nomoto et al. (2020) conducted a cohort in Chronic liver disease with severe thrombocytopenia (n=26). Lusutrombopag was evaluated on Achievement of platelet count ≥ 50,000/µL without requiring platelet transfusion. Lusutrombopag increased platelet counts to ≥ 50,000/µL in 73.1% of patients with chronic liver disease and severe thrombocytopenia, avoiding the need for platelet transfusion.
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