Relationship Between Response to Lusutrombopag and Splenic Volume

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2018 Dec 25

PMID 30581275

Citations 9

Authors

Haruki Uojima

Yoshitaka Arase

Norio Itokawa

Masanori Atsukawa

Takashi Satoh

Koji Miyazaki

Hisashi Hidaka

Ji Hyun Sung

Makoto Kako

Kota Tsuruya

Tatehiro Kagawa

Katsuhiko Iwakiri

Ryouichi Horie

Wasaburo Koizumi

Affiliations

Soon will be listed here.

Abstract

Aim: To assess the correlation between the efficacy of lusutrombopag and clinical characteristics in patients with chronic liver disease.

Methods: In this retrospective, multicenter study, which conducted at four locations in Japan, 50 thrombocytopenic patients with chronic liver disease were enrolled. All patients received oral lusutrombopag (3.0 mg/d for 7 d) for chronic liver disease. We assessed the increase in platelet count after the trial drug administration. A treatment response was defined as a platelet count ≥ 5 × 10/μL and an increased platelet count ≥ 2 × 10/μL from baseline after drug administration. We evaluated the response to lusutrombopag compared to baseline clinical characteristics in patients with chronic liver disease.

Results: The numbers of responders and non-responders were 40 (80.0%) and 10 (20.0%), respectively. The patients were divided into a responder and non-responder group, and we added factors that may correspond to successful treatment with lusutrombopag. Splenic volume and body weight were lower in the responder group than in the non-responder group. White blood cell count and hemoglobin level were higher in responders compared with non-responders. Using a logistic regression model to assess the relationship between response to lusutrombopag and clinical characteristics, multivariate analysis confirmed that splenic volume was an independent factor that predicted the response of platelet counts ( = 0.025; odds ratio = 11.2; 95% confidence interval: 1.354-103.0). Splenic volume negatively correlated to changes in platelet count ( = -0.524, = 0.001).

Conclusion: Splenic volume influences the change in platelet counts after administration of lusutrombopag in patients with chronic liver disease.

Citing Articles

Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre-Treatment Platelet Counts: A Retrospective Multicenter Study.

Suga T, Kakizaki S, Naganuma A, Hatanaka T, Takakusagi S, Takizawa D JGH Open. 2025; 9(1):e70081.

PMID: 39742152 PMC: 11686089. DOI: 10.1002/jgh3.70081.

A study on prevention of bleeding complications using lusutrombopag for safe RFA in patients with hepatocellular carcinoma with low platelet counts: prospective observational study.

Yoshida H, Ohki T, Kanezaki M, Teratani T, Sato S, Obi S BMC Gastroenterol. 2023; 23(1):250.

PMID: 37488476 PMC: 10364390. DOI: 10.1186/s12876-023-02879-0.

Thrombocytopenia in chronic liver disease: Physiopathology and new therapeutic strategies before invasive procedures.

Gallo P, Terracciani F, Di Pasquale G, Esposito M, Picardi A, Vespasiani-Gentilucci U World J Gastroenterol. 2022; 28(30):4061-4074.

PMID: 36157107 PMC: 9403422. DOI: 10.3748/wjg.v28.i30.4061.

Assessing the periprocedural magnitude of platelet count change in response to lusutrombopag.

Brown Jr R, Imawari M, Izumi N, Osaki Y, Bentley R, Ochiai T JHEP Rep. 2021; 3(2):100228.

PMID: 33644726 PMC: 7887643. DOI: 10.1016/j.jhepr.2021.100228.

Lusutrombopag is effective and safe in patients with chronic liver disease and severe thrombocytopenia: a multicenter retrospective study.

Nomoto H, Morimoto N, Miura K, Watanabe S, Takaoka Y, Maeda H BMC Gastroenterol. 2020; 20(1):427.

PMID: 33317473 PMC: 7737263. DOI: 10.1186/s12876-020-01573-9.

References

Hayashi H, Beppu T, Okabe K, Masuda T, Okabe H, Baba H . Risk factors for complications after partial splenic embolization for liver cirrhosis. Br J Surg. 2008; 95(6):744-50. DOI: 10.1002/bjs.6081. View

Eichner E . Splenic function: normal, too much and too little. Am J Med. 1979; 66(2):311-20. DOI: 10.1016/0002-9343(79)90554-0. View

Grotzinger K, Younossi Z, Giannini E, Chen P, Rendas-Baum R, Theodore D . Health-related quality of life in thrombocytopenic patients with chronic hepatitis C with or without cirrhosis in the ENABLE-1 and ENABLE-2 studies. Health Qual Life Outcomes. 2016; 14:49. PMC: 4802726. DOI: 10.1186/s12955-016-0447-1. View

Wong R, Saleh M, Khelif A, Salama A, Portella M, Burgess P . Safety and efficacy of long-term treatment of chronic/persistent ITP with eltrombopag: final results of the EXTEND study. Blood. 2017; 130(23):2527-2536. DOI: 10.1182/blood-2017-04-748707. View

Kim E . Lusutrombopag: First Global Approval. Drugs. 2015; 76(1):155-8. DOI: 10.1007/s40265-015-0525-4. View

Peck-Radosavljevic M . Thrombocytopenia in liver disease. Can J Gastroenterol. 2000; 14 Suppl D:60D-66D. DOI: 10.1155/2000/617428. View

Chow K, Luxembourg B, Seifried E, Bonig H . Spleen Size Is Significantly Influenced by Body Height and Sex: Establishment of Normal Values for Spleen Size at US with a Cohort of 1200 Healthy Individuals. Radiology. 2015; 279(1):306-13. DOI: 10.1148/radiol.2015150887. View

Djordjevic J, Svorcan P, Vrinic D, Dapcevic B . [Splenomegaly and thrombocytopenia in patients with liver cirrhosis]. Vojnosanit Pregl. 2010; 67(2):166-9. DOI: 10.2298/vsp1002166d. View

Hayashi H, Beppu T, Shirabe K, Maehara Y, Baba H . Management of thrombocytopenia due to liver cirrhosis: a review. World J Gastroenterol. 2014; 20(10):2595-605. PMC: 3949268. DOI: 10.3748/wjg.v20.i10.2595. View

10.

Mihaila R, Cipaian R . Eltrombopag in chronic hepatitis C. World J Gastroenterol. 2014; 20(35):12517-21. PMC: 4168085. DOI: 10.3748/wjg.v20.i35.12517. View

11.

Witters P, Freson K, Verslype C, Peerlinck K, Hoylaerts M, Nevens F . Review article: blood platelet number and function in chronic liver disease and cirrhosis. Aliment Pharmacol Ther. 2008; 27(11):1017-29. DOI: 10.1111/j.1365-2036.2008.03674.x. View

12.

Tateishi R, Seike M, Kudo M, Tamai H, Kawazoe S, Katsube T . A randomized controlled trial of lusutrombopag in Japanese patients with chronic liver disease undergoing radiofrequency ablation. J Gastroenterol. 2018; 54(2):171-181. PMC: 6349796. DOI: 10.1007/s00535-018-1499-2. View

13.

Poordad F . Review article: thrombocytopenia in chronic liver disease. Aliment Pharmacol Ther. 2007; 26 Suppl 1:5-11. DOI: 10.1111/j.1365-2036.2007.03510.x. View

14.

Katsube T, Ishibashi T, Kano T, Wajima T . Population Pharmacokinetic and Pharmacodynamic Modeling of Lusutrombopag, a Newly Developed Oral Thrombopoietin Receptor Agonist, in Healthy Subjects. Clin Pharmacokinet. 2016; 55(11):1423-1433. DOI: 10.1007/s40262-016-0411-6. View

15.

Hayashi H, Beppu T, Masuda T, Mizumoto T, Takahashi M, Ishiko T . Predictive factors for platelet increase after partial splenic embolization in liver cirrhosis patients. J Gastroenterol Hepatol. 2007; 22(10):1638-42. DOI: 10.1111/j.1440-1746.2007.05090.x. View

16.

Mitchell O, Feldman D, Diakow M, Sigal S . The pathophysiology of thrombocytopenia in chronic liver disease. Hepat Med. 2016; 8:39-50. PMC: 4847598. DOI: 10.2147/HMER.S74612. View

17.

Elgebaly A, El Ashal G, Elfil M, Menshawy A . Tolerability and Efficacy of Eltrombopag in Chronic Immune Thrombocytopenia: Meta-Analysis of Randomized Controlled Trials. Clin Appl Thromb Hemost. 2016; 23(8):928-937. DOI: 10.1177/1076029616663849. View

18.

Gangireddy V, Kanneganti P, Sridhar S, Talla S, Coleman T . Management of thrombocytopenia in advanced liver disease. Can J Gastroenterol Hepatol. 2014; 28(10):558-64. PMC: 4234356. DOI: 10.1155/2014/532191. View

19.

Hidaka H, Kurosaki M, Tanaka H, Kudo M, Abiru S, Igura T . Lusutrombopag Reduces Need for Platelet Transfusion in Patients With Thrombocytopenia Undergoing Invasive Procedures. Clin Gastroenterol Hepatol. 2018; 17(6):1192-1200. DOI: 10.1016/j.cgh.2018.11.047. View

20.

Dahal S, Upadhyay S, Banjade R, Dhakal P, Khanal N, Bhatt V . Thrombocytopenia in Patients with Chronic Hepatitis C Virus Infection. Mediterr J Hematol Infect Dis. 2017; 9(1):e2017019. PMC: 5333732. DOI: 10.4084/MJHID.2017.019. View