Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Eltrombopag As Steroid Sparing Therapy for Immune Thrombocytopenic Purpura (ITP) in Systemic Lupus Erythemathosus (SLE), Report of Three Cases.
Maroun1, Marie Claire, Ososki2, Rosanne, Andersen1, Judith, Vasey1, Frank B., Dhar1, J. Patricia
To review the efficacy of eltrompobag, as a steroid sparing therapy for ITP associated with SLE.
Eltrobopag activates the thrombopoietin (TPO)surface receptor on the megakaryocyte, which increases the production of platelets, and rapidly improves circulating platelet numbers in patients with ITP. This allows for rapid tapering and/or cessation of corticosteroid therapy. Less is known about the platelet response to this drug in ITP associated with SLE.
Retrospective review was performed of the clinical course of 3 consecutive patients, each with SLE-associated ITP who were initially treated with corticosteroids or other immunomodulatory therapy. These patients were treated with eltrombopag at the DMC Center for Bleeding Disorders and Thrombosis. Eltrompopag was administered according the package insert, with an initial dose of 50 mg daily, with weekly, then monthly monitoring of platelet counts and dose adjustments. Some immunomodulatory agents (e.g. hydroxychloroquine) were continued to control non hematologic SLE manifestions..
All 3 patients maintained acceptable platelet counts (> 50,000/mL, (see graphs) for > 6 months following tapering and cessation of corticosteroids. The drug was well-tolerated and there were no adverse events, and specifically no thrombotic events.
Eltrombopag is effective as a rapidly acting corticosteroid sparing therapy for patients with ITP associated with SLE. This is important in reducing corticosteroid related side effects and morbidities in treating SLE patients with ITP. Larger studies are needed to ascertain safety and efficacy of eltrombopag in SLE patients with ITP, particularly those with coexisting antiphospholipid antibodies.
Figure. Platelets Counts under Eltrombopag
To cite this abstract, please use the following information:
Maroun, Marie Claire, Ososki, Rosanne, Andersen, Judith, Vasey, Frank B., Dhar, J. Patricia; Eltrombopag As Steroid Sparing Therapy for Immune Thrombocytopenic Purpura (ITP) in Systemic Lupus Erythemathosus (SLE), Report of Three Cases. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :629