Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura
Objective: Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by isolated thrombocytopenia. While first-line treatments focus on inhibiting autoantibodies and platelet destruction, second- and third-line treatments include splenectomy and thrombopoietin receptor agonists. In this study, we aimed to compare the efficiency and toxicities of splenectomy and eltrombopag as second-line treatments in ITP.
Materials and Methods: We retrospectively analyzed patients who were diagnosed with ITP and followed between 2015 and 2020. Patients who underwent splenectomy or received eltrombopag treatment as second-line or further therapy were included. For subgroup analyses, patients were further stratified according to whether they received eltrombopag in the second or third line of treatment.
Results: There were 38 patients in the splenectomy group and 47 patients in the eltrombopag group. The mean age of patients in the splenectomy and eltrombopag groups was 43.2 and 50.5 years, respectively. Time to response was significantly shorter in the splenectomy arm (p=0.001). However, response rates at the 3rd, 6th, 12th, and 24th months did not exhibit a statistically significant difference between groups; nor did total duration of response and adverse events. Response rates at the 1st, 3rd, 6th, 12th, and 24th months and the total duration of response did not exhibit a statistically significant difference between eltrombopag subgroups. Eltrombopag treatment was ceased for 20 patients after a median of 54.1 months (range: 1-151). Among them, 12 patients (60%) did not experience a loss of response.
Conclusion: Comparing the splenectomy and eltrombopag arms, even though time to achieve response was in favor of the splenectomy group, this advantage disappeared when overall response rates and response rate at the 2nd year were considered. Using eltrombopag in the second or third line of therapy does not yield any difference in terms of time to achieving response.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Turkish journal of haematology : official journal of Turkish Society of Haematology - 38(2021), 3 vom: 25. Aug., Seite 181-187 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Uğur, Mehmet Can [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Benzoates |
|---|
| Anmerkungen: |
Date Completed 25.01.2022 Date Revised 15.02.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.4274/tjh.galenos.2021.2021.0216 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM327094397 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM327094397 | ||
| 003 | DE-627 | ||
| 005 | 20231225200021.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.4274/tjh.galenos.2021.2021.0216 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1090.xml |
| 035 | |a (DE-627)NLM327094397 | ||
| 035 | |a (NLM)34162173 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Uğur, Mehmet Can |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of Splenectomy and Eltrombopag Treatment in the Second-Line Treatment of Immune Thrombocytopenic Purpura |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.01.2022 | ||
| 500 | |a Date Revised 15.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Objective: Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by isolated thrombocytopenia. While first-line treatments focus on inhibiting autoantibodies and platelet destruction, second- and third-line treatments include splenectomy and thrombopoietin receptor agonists. In this study, we aimed to compare the efficiency and toxicities of splenectomy and eltrombopag as second-line treatments in ITP | ||
| 520 | |a Materials and Methods: We retrospectively analyzed patients who were diagnosed with ITP and followed between 2015 and 2020. Patients who underwent splenectomy or received eltrombopag treatment as second-line or further therapy were included. For subgroup analyses, patients were further stratified according to whether they received eltrombopag in the second or third line of treatment | ||
| 520 | |a Results: There were 38 patients in the splenectomy group and 47 patients in the eltrombopag group. The mean age of patients in the splenectomy and eltrombopag groups was 43.2 and 50.5 years, respectively. Time to response was significantly shorter in the splenectomy arm (p=0.001). However, response rates at the 3rd, 6th, 12th, and 24th months did not exhibit a statistically significant difference between groups; nor did total duration of response and adverse events. Response rates at the 1st, 3rd, 6th, 12th, and 24th months and the total duration of response did not exhibit a statistically significant difference between eltrombopag subgroups. Eltrombopag treatment was ceased for 20 patients after a median of 54.1 months (range: 1-151). Among them, 12 patients (60%) did not experience a loss of response | ||
| 520 | |a Conclusion: Comparing the splenectomy and eltrombopag arms, even though time to achieve response was in favor of the splenectomy group, this advantage disappeared when overall response rates and response rate at the 2nd year were considered. Using eltrombopag in the second or third line of therapy does not yield any difference in terms of time to achieving response | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Thrombocytopenia | |
| 650 | 4 | |a Eltrombopag | |
| 650 | 4 | |a Splenectomy | |
| 650 | 7 | |a Benzoates |2 NLM | |
| 650 | 7 | |a Hydrazines |2 NLM | |
| 650 | 7 | |a Pyrazoles |2 NLM | |
| 650 | 7 | |a eltrombopag |2 NLM | |
| 650 | 7 | |a S56D65XJ9G |2 NLM | |
| 700 | 1 | |a Namdaroğlu, Sinem |e verfasserin |4 aut | |
| 700 | 1 | |a Doğan, Esma Evrim |e verfasserin |4 aut | |
| 700 | 1 | |a Turan Erkek, Esra |e verfasserin |4 aut | |
| 700 | 1 | |a Nizam, Nihan |e verfasserin |4 aut | |
| 700 | 1 | |a Eren, Rafet |e verfasserin |4 aut | |
| 700 | 1 | |a Bilgir, Oktay |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Turkish journal of haematology : official journal of Turkish Society of Haematology |d 1998 |g 38(2021), 3 vom: 25. Aug., Seite 181-187 |w (DE-627)NLM095465758 |x 1308-5263 |7 nnns |
| 773 | 1 | 8 | |g volume:38 |g year:2021 |g number:3 |g day:25 |g month:08 |g pages:181-187 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.4274/tjh.galenos.2021.2021.0216 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 38 |j 2021 |e 3 |b 25 |c 08 |h 181-187 | ||