Combining thrombopoietin receptor agonists with immunosuppressive drugs in adult patients with multirefractory immune thrombocytopenia, an update on the French experience - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue British Journal of Haematology Année : 2023

Combining thrombopoietin receptor agonists with immunosuppressive drugs in adult patients with multirefractory immune thrombocytopenia, an update on the French experience

Odile Souchaud-Debouverie
  • Fonction : Auteur
Philippe Audeguy
  • Fonction : Auteur
Mohamed Hamidou
  • Fonction : Auteur
Selim Corm
  • Fonction : Auteur
Christelle Mausservey
  • Fonction : Auteur
Nicolas Limal
  • Fonction : Auteur
Marc Michel
  • Fonction : Auteur
Bertrand Godeau
  • Fonction : Auteur
Matthieu Mahévas

Résumé

Combining drugs could be an effective option for treating multirefractory ITP, that is, patients not responding to rituximab, thrombopoietin receptor agonists (TPO-RA) and splenectomy. We conducted a retrospective, multicenter, observational study including multirefractory ITP patients who received a combination of a TPO-RA and an immunosuppressive drug. We included 39 patients (67% women, median age 59 years [range 21-96]), with a median ITP duration of 57 months [3-393] and a median platelet count at initiation of 10 × 109 /L [1-35]. The combination regimen was given for a median duration of 12 months [1-103] and included eltrombopag (51%) or romiplostim (49%), associated with mycophenolate mofetil (54%), azathioprine (36%), cyclophosphamide (5%), cyclosporin (3%) or everolimus (3%). Overall, 30 patients (77%) achieved at least a response (platelet count ≥30 × 109 /L and at least doubling baseline during at least 3 months), including 24 complete responses (platelet count >100 × 109 /L during at least 3 months) with a median time to response of 30 days [7-270] and a median duration of response of 15 months [4-63]. Severe adverse event related to ITP treatment was observed in 31%. In conclusion, this study confirms that some patients with multirefractory ITP can achieve long lasting response with this combination.

Dates et versions

hal-04113859 , version 1 (01-06-2023)

Identifiants

Citer

Etienne Crickx, Mikael Ebbo, Etienne Rivière, Odile Souchaud-Debouverie, Louis Terriou, et al.. Combining thrombopoietin receptor agonists with immunosuppressive drugs in adult patients with multirefractory immune thrombocytopenia, an update on the French experience. British Journal of Haematology, 2023, ⟨10.1111/bjh.18893⟩. ⟨hal-04113859⟩
36 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More