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2017 ; 2017
(ä): 4109605
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Sustained Remission in Patients with Primary Immune Thrombocytopenia after
Romiplostim Tapering and Discontinuation: A Case Series in Real Life Management
in Spain
#MMPMID28695025
Mingot-Castellano ME
; Grande-García C
; Valcárcel-Ferreiras D
; Conill-Cortés C
; de Olivar-Oliver L
Case Rep Hematol
2017[]; 2017
(ä): 4109605
PMID28695025
show ga
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 × 10(9)/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.