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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Hematol
2018 ; 93
(7
): 921-930
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
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English Wikipedia
Fostamatinib for the treatment of adult persistent and chronic immune
thrombocytopenia: Results of two phase 3, randomized, placebo-controlled trials
#MMPMID29696684
Bussel J
; Arnold DM
; Grossbard E
; Mayer J
; Treli?ski J
; Homenda W
; Hellmann A
; Windyga J
; Sivcheva L
; Khalafallah AA
; Zaja F
; Cooper N
; Markovtsov V
; Zayed H
; Duliege AM
Am J Hematol
2018[Jul]; 93
(7
): 921-930
PMID29696684
show ga
Spleen tyrosine kinase (Syk) signaling is central to phagocytosis-based,
antibody-mediated platelet destruction in adults with immune thrombocytopenia
(ITP). Fostamatinib, an oral Syk inhibitor, produced sustained on-treatment
responses in a phase 2 ITP study. In two parallel, phase 3, multicenter,
randomized, double-blind, placebo-controlled trials (FIT1 and FIT2), patients
with persistent/chronic ITP were randomized 2:1 to fostamatinib (n?=?101) or
placebo (n?=?49) at 100 mg BID for 24 weeks with a dose increase in nonresponders
to 150 mg BID after 4 weeks. The primary endpoint was stable response (platelets
?50 000/?L at ?4 of 6 biweekly visits, weeks 14-24, without rescue therapy).
Baseline median platelet count was 16 000/?L; median duration of ITP was 8.5
years. Stable responses occurred in 18% of patients on fostamatinib vs. 2% on
placebo (P?=?.0003). Overall responses (defined retrospectively as ?1 platelet
count ?50 000/?L within the first 12 weeks on treatment) occurred in 43% of
patients on fostamatinib vs. 14% on placebo (P?=?.0006). Median time to response
was 15 days (on 100 mg bid), and 83% responded within 8 weeks. The most common
adverse events were diarrhea (31% on fostamatinib vs. 15% on placebo),
hypertension (28% vs. 13%), nausea (19% vs. 8%), dizziness (11% vs. 8%), and ALT
increase (11% vs. 0%). Most events were mild or moderate and resolved
spontaneously or with medical management (antihypertensive, anti-motility
agents). Fostamatinib produced clinically-meaningful responses in ITP patients
including those who failed splenectomy, thrombopoietic agents, and/or rituximab.
Fostamatinib is a novel ITP treatment option that targets an important mechanism
of ITP pathogenesis.
|Adult
[MESH]
|Aminopyridines
[MESH]
|Blood Platelets/drug effects
[MESH]
|Chronic Disease
[MESH]
|Humans
[MESH]
|Morpholines
[MESH]
|Oxazines/*administration & dosage/adverse effects/therapeutic use
[MESH]