Considerations in the management of hepatitis C virus-related thrombocytopenia with eltrombopag

Thrombocytopenia is a common clinical problem in HCV-infected cases. Multiple studies have consistently shown a rise in platelet count following a successful HCV treatment thus proving a cause-effect relationship between the two. Although, many therapeutic strategies have been tried in the past to t...

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Bibliographic Details
Published in:Saudi journal of gastroenterology 2010-01, Vol.16 (1), p.51-56
Main Authors: Danish, Fazal A, Koul, Salman S, Subhani, Fazal R, Rabbani, Ahmed E, Yasmin, Saeeda
Format: Article
Language:English
Subjects:
Analysis
Benzoates - therapeutic use
Binding sites
Bone marrow
Care and treatment
Complications and side effects
Diagnosis
Drug therapy
Eltrombopag
Health aspects
Hepatitis C
Hepatitis C - complications
Hepatitis C - drug therapy
Hepatitis C virus
Human subjects
Humans
Hydrazines - therapeutic use
New Horizon
Pyrazoles - therapeutic use
Risk factors
Signal transduction
Studies
Thrombocytopenia
Thrombocytopenia - drug therapy
Thrombocytopenia - etiology
Treatment Outcome
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Summary:Thrombocytopenia is a common clinical problem in HCV-infected cases. Multiple studies have consistently shown a rise in platelet count following a successful HCV treatment thus proving a cause-effect relationship between the two. Although, many therapeutic strategies have been tried in the past to treat HCV-related thrombocytopenia (e.g. interferon dose reductions, oral steroids, intravenous immunoglobulins, splenectomy etc), the success rates have been variable and not always reproducible. After the cessation of clinical trials of PEG-rHuMGDF due to immunogenecity issues, the introduction of non-immunogenic second-generation thrombopoietin-mimetics (eltrombopag and Romiplostim) has opened up a novel way to treat HCV-related thrombocytopenia. Although the data is still sparse, eltrombopag therapy has shown to successfully achieve the primary endpoint platelet counts of >/=50,000/muL in phase II& III, randomized, double-blind, placebo-controlled trials. Likewise, though it is premature to claim safety of this drug especially in high-risk patient groups, reported side effects in the published literature were of insufficient severity to require discontinuation of the drug. Based on the current and emerging evidence, a review of the pharmacologic basis, pharmacokinetics, therapeutic efficacy, safety profile and future considerations of eltrombopag in the context of HCV-related thrombocytopenia is given in this article. A MEDLINE search was conducted (1990 to August 2009) using the search terms eltrombopag, HCV, thrombocytopenia.
ISSN:1319-3767
1998-4049
DOI:10.4103/1319-3767.58772