Real-life experience of lusutrombopag for cirrhotic patients with low platelet counts being prepared for invasive procedures

• Published in: PloS one 2019-02, Vol.14 (2), p.e0211122
• Main Authors: Takada, Hitomi, Kurosaki, Masayuki, Nakanishi, Hiroyuki, Takahashi, Yuka, Itakura, Jun, Tsuchiya, Kaoru, Yasui, Yutaka, Tamaki, Nobuharu, Takaura, Kenta, Komiyama, Yasuyuki, Higuchi, Mayu, Kubota, Youhei, Wang, Wann, Okada, Mao, Shimizu, Takao, Watakabe, Keiya, Enomoto, Nobuyuki, Izumi, Namiki
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Aged; Alcohol; Analysis; Biology and Life Sciences; Blood cell count; Blood diseases; Blood platelets; Bone marrow; Cancer therapies; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - therapy; Catheter Ablation; Chemoembolization, Therapeutic; Chemotherapy; Cinnamates - therapeutic use; Consent; Diagnostic imaging; Dosage and administration; Drug therapy; Endoscopy; Esophageal and Gastric Varices - blood; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - therapy; Esophagus; Female; Gastroenterology; Hemorrhage; Hepatitis; Hepatology; Hospitals; Humans; Infections; Internal medicine; Liver cancer; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Liver diseases; Liver Neoplasms - blood; Liver Neoplasms - complications; Liver Neoplasms - therapy; Lusutrombopag; Male; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Patient outcomes; Patients; Platelet Count; Platelet Transfusion; Platelets; Radio frequency; Receptors, Thrombopoietin - agonists; Research and Analysis Methods; Retrospective Studies; Sclerotherapy; Spleen; Thiazoles - therapeutic use; Thrombocytopenia; Thrombocytopenia - blood; Thrombocytopenia - complications; Thrombocytopenia - drug therapy; Thromboembolism; Thrombolysis; Thrombosis; Transfusion; Ultrasound; Ultrasound imaging; Viral infections
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0211122

The present study aimed to report our real-life experience of the TPO receptor agonist lusutrombopag for cirrhotic patients with low platelet counts. We studied platelet counts in 1,760 cirrhotic patients undergoing invasive procedures at our hospital between January 2014 and December 2017. In addition, we studied 25 patients who were administered lusutrombopag before invasive procedures between June 2017 and January 2018. Effectiveness of lusutrombopag to raise platelet counts and to avoid transfusion and treatment-related adverse events were analyzed. In 1,760 cirrhotic patients without lusutrombopag prior to invasive procedures, proportion of patients whose platelet counts 30,000/μL (n = 17) (50,000 ± 20,000 vs 86,000 ± 26,000/μL, p = 0.002). Patients with a baseline platelet count ≤30,000/μL with spleen index (calculated by multiplying the transverse diameter by the vertical diameter measured by ultrasonography) ≥40 cm2 (n = 3) had a lower response rate to lusutrombopag compared to those with spleen index