Abstract Number: PB1208
Meeting: ISTH 2022 Congress
Theme: Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies » Acquired Thrombocytopenias
Background: Thrombopoietin receptor agonists (TPO-RAs) have become the second line treatment for immune thrombocytopenia (ITP) patients. Despite TPO-RAs are currently indicated for continuous treatment, some patients can achieve a sustained response that allows tapering and discontinuation. Predictors of responses and relapses after discontinuation are unknown factors that are being under investigation.
Aims: We aimed to determine the proportion of patients achieving long-term remission after TPO-RAs discontinuation.
Methods: This is a retrospective study approved by Hospital Universitario La Paz Ethical Committee. In a preliminary analysis, we described our experience of 10 years in discontinuation of TPO-RAs and relapses in the ITP patient cohort from Hospital Universitario La Paz in Madrid.
Results: One-hundred-fifty-one ITP patients were treated with TPO-RAs between 1st January 2011 and 31st December 2020. We excluded those without complete information, analyzing a total of 133 patients. Thirteen received Romiplostim, 7 men and 4 women, with a median age of 66y (range 3-98). All of them achieved a clinical response according to standard criteria and in four it was possible to discontinue TPO-AR, with no need of retreatment. Seventy-five patients were treated with Eltrombopag, 35 men and 49 women, with a median age of 49y (range 1-98). Seventy-one patients got a clinical response, which allows discontinuation of TPO-AR in 43 of them, with 25 sustained responses. We also included 45 ITP patients, 21 men and 24 women, median age of 53y (range 2-93), who received both TPO-AR because of lack of response or intolerance with the first (4 Romiplostim and 41 Eltrombopag). Among the 34 patients who achieved a response, 17 were able to discontinue TPO-ARs and 7 needed retreatments. Globally, 39 patients discontinue TPO-RAs with no need of further ITP treatment. Results are summarized in Table 1.
Conclusion(s): Twenty-nine% (39/113) of ITP patients who were treated with TPO-RAs could discontinue this treatment without relapses.
Table 1
-1-: Percentages are referred to the total population in each group. -2-: Percentages are referred to the discontinuation population in each group.
To cite this abstract in AMA style:
Ramírez López A, Alvarez-Román M, Martín Salces M, Rivas Pollmar M, Monzón Manzano E, Arias Salgado E, Acuña P, Jiménez Yuste V, Butta N. Discontinuation of thrombopoietin receptor agonists: a 10 year real-world experience from an academic hospital in Madrid [abstract]. https://abstracts.isth.org/abstract/discontinuation-of-thrombopoietin-receptor-agonists-a-10-year-real-world-experience-from-an-academic-hospital-in-madrid/. Accessed October 1, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/discontinuation-of-thrombopoietin-receptor-agonists-a-10-year-real-world-experience-from-an-academic-hospital-in-madrid/