Abstract No. 616 Lusutrombopag is a safe treatment option for thrombocytopenia in patients with chronic liver disease undergoing a planned invasive procedure: pooled safety analysis from three studies
Lusutrombopag (LUSU) is a thrombopoietin receptor agonist (TPO-RA) approved in Japan and US for treatment of thrombocytopenia (TCP), and in EU for severe TCP, associated with chronic liver disease (CLD) in patients undergoing planned invasive procedures (IP). TPO-RAs have been associated with increased risk of thrombotic events in patients with CLD and a safety assessment of new agents is critical. LUSU safety was assessed in a pooled retrospective analysis of three clinical studies.
Thrombocytopenia is a known complication of chronic liver disease that results from a myriad of mechanisms. The most commonly accepted hypotheses include the development of splenomegaly from portal hypertension with consequent hypersplenism (pooling and sequestration of blood cells), as well as a more central mechanism involving reduced production of thrombopoietin by the damaged liver leading to diminished thrombopoiesis in the bone marrow [1,2]. Thrombocytopenia is therefore assumed to be a direct expression of liver fibrosis in individuals with liver disease.
Semin Thromb Hemost DOI: 10.1055/s-0040-1708842The impact of thrombocytopenia varies widely depending on the underlying pathophysiology driving it. The biggest challenge in managing thrombocytopenia in pregnancy is accurately identifying the responsible pathophysiology—a task made difficult given the tremendous overlap in clinical and laboratory abnormalities associated with different thrombocytopenia processes. The most common etiologies of thrombocytopenia in pregnancy range from physiology deemed benign to those that are life-threatening to the mother and fetus. Even in cases in which the responsible etiology is d...
CONCLUSION: This study revealed that Lusutrombopag was more sufficiently effective in CLD patients compared with platelet transfusion and that renal function is independent predictor of increase. Factors indicative of renal function significantly and negatively correlated with increase in platelets. PMID: 32238734 [PubMed - as supplied by publisher]
Patients with hepatocellular carcinoma (HCC) secondary to chronic liver disease often require invasive procedures, but frequently have thrombocytopenia. Lusutrombopag is an agonist of the thrombopoietin receptor that activates platelet production.
Lusutrombopag is an oral, small molecule thrombopoietin receptor agonist approved in Japan and US for treatment of thrombocytopenia (TCP), and in EU for severe TCP, associated with chronic liver disease (CLD) in patients undergoing planned invasive procedures. The degree of TCP may impact treatment response to lusutrombopag and the need for platelet transfusion (PT). This analysis evaluates the increase in platelet count (PC) and maximum PC achieved according to baseline PC.
Lusutrombopag (LUSU) is an oral, small molecule thrombopoietin receptor agonist approved in Japan and US for treatment of thrombocytopenia (TCP), and in EU for severe TCP, associated with chronic liver disease (CLD) in patients undergoing planned invasive procedures (IPs). This integrated analysis assessed the consistency of the efficacy and safety of LUSU clinical trial data across a larger population.
Gaucher disease (GD), a rare lysosomal storage disorder caused by deficient glucocerebrosidase activity and consequent accumulation of glycosphingolipids in the mononuclear phagocyte system, may progress to disabling and potentially life-threatening complications when left undiagnosed and untreated. Unfortunately, because of non-specific signs and symptoms and lack of awareness, patients with type 1 GD, the most common non-neuropathic variant, frequently experience diagnostic delays. Since splenomegaly and thrombocytopenia are the dominant clinical features in many GD patients leading to first medical contact, the hepatolo...
CONCLUSIONS: Peritransplant interventions for spontaneous splenorenal shunt may reduce posttransplant acute kidney injury. In patients without intervention, spontaneous splenorenal shunt predominantly persisted 1 year posttransplant. PMID: 32039670 [PubMed - as supplied by publisher]
ConclusionsUnder a combination of leflunomide and methotrexate, liver toxicity and, for the first time, thrombotic microangiopathy occurred as side effects. Non-alcoholic fatty liver disease may have predisposed for the drug-induced liver toxicity.
Background: Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices.Objectives: We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic.Methods: We studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accuracy.Results: We...