Abstract Number: PB1378
Meeting: ISTH 2020 Congress
Background: ITP is an immune-mediated disease resulting in platelet destruction and diminished platelet production. Corticosteroids are often used as first line treatment for ITP. New societal guidelines and an international consensus statement (Neunert, 2019 and Provan, 2019) suggest limiting the utilization of corticosteroids in ITP patients due to untoward side effects and safety concerns. Ideally, second line treatment options in ITP would allow for dose reduction or discontinuation of steroids. Avatrombopag (AVA) is an oral thrombopoietin-receptor agonist approved for adult patients with chronic ITP who have failed a previous treatment.
Aims: The objective of these analyses was to characterize the reduction in baseline corticosteroid use in patients who received AVA for the treatment of chronic ITP.
Methods: A 6-month, multicenter, randomized, double-blind, phase 3 study enrolled 32 AVA and 17 placebo-treated patients with chronic ITP. Eligible patients could enter a 96-week open-label extension period following the core study. Stable doses of corticosteroids were allowed at baseline and continued use was permitted. During weeks 6 to 18 of the core study and after the first 6 weeks of the extension, the investigator was allowed to decrease the dose and/or discontinue the use of corticosteroids in conjunction with study drug titration if needed. The proportion of patients able to reduce corticosteroid use without the need for rescue treatment during either the core or extension phase of the study was evaluated.
Results: At baseline, 14 AVA and 7 placebo-treated patients used baseline concomitant corticosteroid medication. Six patients originally randomized to AVA (42.9%) were able to either reduce or discontinue baseline concomitant corticosteroid. During the extension, patients who received placebo during the core study were switched to AVA, and 4 additional patients were subsequently able to reduce corticosteroid dose (57.1%).
Conclusions: Avatrombopag use allowed for the reduction or discontinuation of corticosteroids in ITP patients.
To cite this abstract in AMA style:Recht M, Dixon A, Aggarwal K, Vredenburg M. Corticosteroid Reduction or Discontinuation after Initiation of Avatrombopag Treatment in Patients with Chronic Immune Thrombocytopenia (ITP) [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/corticosteroid-reduction-or-discontinuation-after-initiation-of-avatrombopag-treatment-in-patients-with-chronic-immune-thrombocytopenia-itp/. Accessed January 23, 2022.
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