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10.1002/ajh.25125

http://scihub22266oqcxt.onion/10.1002/ajh.25125
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suck abstract from ncbi


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pmid29696684
      Am+J+Hematol 2018 ; 93 (7 ): 921-930
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  • 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]
  • |Platelet Count [MESH]
  • |Purpura, Thrombocytopenic, Idiopathic/*drug therapy [MESH]
  • |Pyridines/*administration & dosage/adverse effects/therapeutic use [MESH]
  • |Pyrimidines [MESH]
  • |Splenectomy [MESH]
  • |Syk Kinase/administration & dosage/therapeutic use [MESH]


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