Efficacy and safety of eltrombopag in persistent and newly diagnosed ITP in clinical practice

Tomás José González-López, Fernando Fernández-Fuertes, José Angel Hernández-Rivas, Blanca Sánchez-González, Violeta Martínez-Robles, María Teresa Alvarez-Román, Gloria Pérez-Rus, Cristina Pascual, Silvia Bernat, Esther Arrieta-Cerdán, Carlos Aguilar, Abelardo Bárez, María Jesús Peñarrubia, Pavel Olivera, Angeles Fernández-Rodríguez, Erik de Cabo, Luis Javier García-Frade, José Ramón González-Porras

Eltrombopag is safe and effective in primary chronic ITP. However, lack of clinical trials avoids a clear demonstration of its utility in newly diagnosed and persistent ITP. Our aim here is to report Spanish results for this type of patients. We retrospectively evaluated 220 adult primary ITP patients. According to standard definition, patients were allocated to newly diagnosed (n = 30), persistent (n = 30), and chronic (n = 160) ITP. Groups were homogenous regarding most relevant parameters. 180 (90%) of 220 patients achieved a platelet response (R) with 167 (75.9%) complete responses (CR) after a 15-month follow-up. No statistical significant differences among groups but a trend towards a greater efficacy in newly diagnosed ITP were observed (93.3% of responses with 86.7% of CR). Efficacy in persistent ITP (83.3% of responses with 80.0% of CR) and chronic ITP (79.4% of responses with 73.1% of CR) was similar. 70 patients (31.8%) experienced adverse events. 15 of them were grade 3-4. Most common adverse effects were headache and hepatobiliary laboratory abnormalities (HBLAs). One persistent ITP had a venous thrombosis and one chronic ITP had grade II myelofibrosis. We consider Eltrombopag use for the early stage ITP as effective and safe as it is in chronic ITP.