Avespa Study: Effectiveness and Safety of Avatrombopag in Immune Thrombocytopenia (ITP). a Real-World Study of the Spanish ITP Group (GEPTI)

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.713-713
• Main Authors: Pascual Izquierdo, Maria Cristina, Sanchez Gonzalez, Blanca, Canaro Hinryk, Mariana, García-Donas Gabaldón, Gloria, Menor Gómez, María, Gil Fernandez, Juan Jose, Monsalvo Saornil, Silvia, Alvarez Roman, Maria Teresa, Jarque, Isidro, Llácer Ferrandis, María José, Zafra, Denis, Caparros Miranda, Isabel, Ortúzar Pasalodos, Ariana, Revilla, Nuria, Bastida Bermejo, Jose Maria, Alvarellos Outeiro, Montserrat, Jimenez Barcenas, Reyes, Bernat, Silvia Bernat, Chica Gullón, Esther, Martinez Carballeira, Daniel, Lakhwani, Sunil, Lopez Ansoar, Elsa, Moreno Beltran, Esperanza, Lorenzo Vizcaya, Alvaro, Canet Maldonado, Marta, Gonzalez y Gascon, Isabel, Caballero Navarro, Gonzalo, Cuesta, Amalia, Pedrote, Begoña, Aguirre Arrizabalaga, Maria Aranzazu, Lasa Eguialde, Maialen, Moreno Carbonell, Marta, Ortiz López, Alicia, Mingot Castellano, Eva
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-200861

Background Thrombopoietin receptor analogues (TPO-RAs) are recommended as second-line treatment for immune thrombocytopenia (ITP). Avatrombopag (AVA) is the last oral AR-TPO approved for use in Spain and also recommended for second-line use, for which few real-life data are currently available. Our objective is to evaluate the effectiveness and safety of AVA in severe and moderate/mild ITP patients, including those who have not responded to other treatments; to explore AVA's potential to reduce concomitant immunosuppressive therapies and compare its efficacy and safety in newly diagnosed/persistent ITP patients with those with chronic ITP. Methods The AVESPA study was a national, multicenter, retrospective study conducted by The Spanish ITP Group (GEPTI) of the Spanish Society of Haematology and Haemotherapy (SEHH). The study enrolled patients diagnosed with chronic, persistent, newly diagnosed ITP who began treatment with AVA from July 2022 to January 2024. The study assessed rates and time to response (R) (>50x109/L) and complete response (CR) (>100x109/L), duration of response (DOR), loss of response (LOR), adverse events (AEs), and treatment withdrawal before the end of follow-up. The calculations were performed for the entire cohort and in patients who initially presented with severe (3 lines of treatment, respectively. In the severe ITP group, 154/193 (79.8%) and 20/193 (10.4%) patients achieved complete response (CR, [PC>100x109/L) and response (R, PC>50x109/L), respectively. Among 129 severe ITP patients who were still on AVA at their last visit, 87(67.4%) and 26(20.1%) had CR and R, respectively. Results were similar in the 104 severe ITP patients who switched to AVA due to previous treatment failure. Severe ITP patients reached R and CR in 13 (7-21) and 14 (9-35) days, respectively. Eighty-seven percent of