The temporary use of thrombopoietin-receptor agonists may induce a prolonged remission in adult chronic immune thrombocytopenia. Results of a French observational study

Br J Haematol. 2014 Jun;165(6):865-9. doi: 10.1111/bjh.12888. Epub 2014 Apr 12.

Abstract

Thrombopoietin-receptor agonists (Tpo-RAs) are highly effective in immune thrombocytopenia (ITP). Recently, cases of durable remission after Tpo-RA discontinuation in adult ITP have been reported. We aimed to describe the subset of patients in whom transient Tpo-RA therapy may induce a durable response. We studied all adults with primary ITP treated with at least one Tpo-RA over a 5-year period (n = 54) and seen at one of three participating referral centres in France. Tpo-RAs were discontinued in 20 of 28 patients who achieved a complete response. We excluded six patients because a previous treatment at the start of Tpo-RA treatment may have interfered with the response. Overall, eight patients with chronic ITP showed a sustained response [median follow-up: 13·5 months (range 5-27 months)]. We could not identify a predictive factor of sustained response. In conclusion, a substantial proportion of ITP patients receiving Tpo-RAs can maintain a durable response after treatment discontinuation.

Keywords: durable response; immune thrombocytopenia; prolonged remission; thrombopoietin-receptor agonists.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Benzoates / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • France
  • Humans
  • Hydrazines / therapeutic use*
  • Immunologic Factors / therapeutic use
  • Male
  • Middle Aged
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Purpura, Thrombocytopenic, Idiopathic / surgery
  • Pyrazoles / therapeutic use*
  • Receptors, Fc / therapeutic use*
  • Receptors, Thrombopoietin / agonists*
  • Recombinant Fusion Proteins / therapeutic use*
  • Splenectomy
  • Thrombopoietin / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Benzoates
  • Hydrazines
  • Immunologic Factors
  • Pyrazoles
  • Receptors, Fc
  • Receptors, Thrombopoietin
  • Recombinant Fusion Proteins
  • Thrombopoietin
  • romiplostim
  • eltrombopag