Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain
Romiplostim, a thrombopoietin-receptor agonist (TPO-ra), is a highly effective option in primary immune thrombocytopenia (ITP), with 80–90% of patients achieving platelet responses after few weeks of treatment. The evidence showing remissions, that is, sustained platelet counts after romiplostim dis...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/4109605 |
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| author | María-Eva Mingot-Castellano Carlos Grande-García David Valcárcel-Ferreiras Clara Conill-Cortés Loreto de Olivar-Oliver |
| author_facet | María-Eva Mingot-Castellano Carlos Grande-García David Valcárcel-Ferreiras Clara Conill-Cortés Loreto de Olivar-Oliver |
| author_sort | María-Eva Mingot-Castellano |
| collection | DOAJ |
| description | Romiplostim, a thrombopoietin-receptor agonist (TPO-ra), is a highly effective option in primary immune thrombocytopenia (ITP), with 80–90% of patients achieving platelet responses after few weeks of treatment. The evidence showing remissions, that is, sustained platelet counts after romiplostim discontinuation, in patients with ITP refractory to immunosuppressive therapy is steadily increasing. However, there is a lack of guidelines or recommendations addressing how and when to taper romiplostim in clinical practice in patients maintaining elevated and stable platelet counts. Furthermore, given the high heterogeneity of ITP patients, no associated predictive factors have been currently identified. Here, we present 4 representative clinical cases of the daily clinical practice in Spain comprising newly diagnosed, persistent, and both splenectomized and nonsplenectomized chronic ITP patients treated with romiplostim, achieving and maintaining clinical remission (platelet count ≥ 50 × 109/L for 24 consecutive weeks in the absence of any treatment for ITP) after treatment tapering and discontinuation, without observed safety concerns. Prospective studies identifying clinical and biological predictive factors of sustained response are warranted. |
| format | Article |
| id | doaj-art-4dddb6c22ad743c3a567ef280b6c2498 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-4dddb6c22ad743c3a567ef280b6c24982025-02-03T05:58:48ZengWileyCase Reports in Hematology2090-65602090-65792017-01-01201710.1155/2017/41096054109605Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in SpainMaría-Eva Mingot-Castellano0Carlos Grande-García1David Valcárcel-Ferreiras2Clara Conill-Cortés3Loreto de Olivar-Oliver4Hematology Department, Hospital Regional Universitario de Málaga, Av. de Carlos Haya, s/n, 29010 Málaga, SpainHematology Department, Hospital Universitario 12 de Octubre, Avda. Córdoba, s/n, 28041 Madrid, SpainHematology Department, Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, SpainAmgen S.A., Moll de Barcelona, Edifici Sud, Planta 7, 08039 Barcelona, SpainAmgen S.A., Moll de Barcelona, Edifici Sud, Planta 7, 08039 Barcelona, SpainRomiplostim, a thrombopoietin-receptor agonist (TPO-ra), is a highly effective option in primary immune thrombocytopenia (ITP), with 80–90% of patients achieving platelet responses after few weeks of treatment. The evidence showing remissions, that is, sustained platelet counts after romiplostim discontinuation, in patients with ITP refractory to immunosuppressive therapy is steadily increasing. However, there is a lack of guidelines or recommendations addressing how and when to taper romiplostim in clinical practice in patients maintaining elevated and stable platelet counts. Furthermore, given the high heterogeneity of ITP patients, no associated predictive factors have been currently identified. Here, we present 4 representative clinical cases of the daily clinical practice in Spain comprising newly diagnosed, persistent, and both splenectomized and nonsplenectomized chronic ITP patients treated with romiplostim, achieving and maintaining clinical remission (platelet count ≥ 50 × 109/L for 24 consecutive weeks in the absence of any treatment for ITP) after treatment tapering and discontinuation, without observed safety concerns. Prospective studies identifying clinical and biological predictive factors of sustained response are warranted.http://dx.doi.org/10.1155/2017/4109605 |
| spellingShingle | María-Eva Mingot-Castellano Carlos Grande-García David Valcárcel-Ferreiras Clara Conill-Cortés Loreto de Olivar-Oliver Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain Case Reports in Hematology |
| title | Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain |
| title_full | Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain |
| title_fullStr | Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain |
| title_full_unstemmed | Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain |
| title_short | Sustained Remission in Patients with Primary Immune Thrombocytopenia after Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management in Spain |
| title_sort | sustained remission in patients with primary immune thrombocytopenia after romiplostim tapering and discontinuation a case series in real life management in spain |
| url | http://dx.doi.org/10.1155/2017/4109605 |
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