Naohisa Wada1, Haruki Uojima2, Takashi Satoh3,4, Sosei Okina5, Shuichiro Iwasaki1, Xue Shao1, Hayato Takiguchi4, Yoshitaka Arase6, Norio Itokawa7, Masanori Atsukawa8, Koji Miyazaki9, Hisashi Hidaka1, Makoto Kako10, Tatehiro Kagawa6, Katsuhiko Iwakiri7, Ryouichi Horie3,4, Takahiro Suzuki5, Wasaburo Koizumi1. 1. Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 2. Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan, kiruha@kitasato-u.ac.jp. 3. Division of Hematology, Department of Medical Laboratory Sciences, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. 4. Division of Molecular Hematology, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan. 5. Department of Hematology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 6. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Sagamihara, Japan. 7. Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan. 8. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan. 9. Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Japan. 10. Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Japan.
Abstract
BACKGROUND: To make an accurate estimate of the response to thrombopoietin (TPO) receptor agonists for thrombocytopenia associated with chronic liver disease, we evaluated the influence of antiplatelet autoantibodies on the response to lusutrombopag in thrombocytopenic patients with liver disease. METHODS: A prospective study was conducted at 2 hospitals. Thrombocytopenic patients with liver disease received oral lusutrombopag 3.0 mg once daily for up to 7 days. We analyzed changes in platelet counts from baseline to the maximum platelet count on days 9-14. The definition of clinical response was a platelet count of ≥5 × 104/μL with an increased platelet count of ≥2 × 104/μL from baseline. We assessed the correlation between the response to treatment drug and antiplatelet autoantibodies measured by anti-GPIIb/IIIa antibody-producing B cells. RESULTS: Thirty patients received the trial drug. There were 25 responders and 5 nonresponders. The median change in platelet counts was 3.9 × 104/μL (95% CI 2.8-4.6, p < 0.0001). The correlation between change in platelet counts and the frequency of the anti-glycoprotein IIb/IIIa antibody-producing B cells was moderate (r = 0.414, 95% CI 0.064-0.674, p = 0.023). In multivariate analysis of factors affecting the change in platelet counts, the anti-GPIIb/IIIa antibody-producing B cells were identified as an independent factor (regression coefficient [B] = 0.089; CI 0.021-0.157, p = 0.013). CONCLUSION: Anti-GPIIb/IIIa antibody-producing B cells may be a predictor for TPO receptor agonists in patients with chronic liver disease.
BACKGROUND: To make an accurate estimate of the response to thrombopoietin (TPO) receptor agonists for thrombocytopenia associated with chronic liver disease, we evaluated the influence of antiplatelet autoantibodies on the response to lusutrombopag in thrombocytopenicpatients with liver disease. METHODS: A prospective study was conducted at 2 hospitals. Thrombocytopenicpatients with liver disease received oral lusutrombopag 3.0 mg once daily for up to 7 days. We analyzed changes in platelet counts from baseline to the maximum platelet count on days 9-14. The definition of clinical response was a platelet count of ≥5 × 104/μL with an increased platelet count of ≥2 × 104/μL from baseline. We assessed the correlation between the response to treatment drug and antiplatelet autoantibodies measured by anti-GPIIb/IIIa antibody-producing B cells. RESULTS: Thirty patients received the trial drug. There were 25 responders and 5 nonresponders. The median change in platelet counts was 3.9 × 104/μL (95% CI 2.8-4.6, p < 0.0001). The correlation between change in platelet counts and the frequency of the anti-glycoprotein IIb/IIIa antibody-producing B cells was moderate (r = 0.414, 95% CI 0.064-0.674, p = 0.023). In multivariate analysis of factors affecting the change in platelet counts, the anti-GPIIb/IIIa antibody-producing B cells were identified as an independent factor (regression coefficient [B] = 0.089; CI 0.021-0.157, p = 0.013). CONCLUSION: Anti-GPIIb/IIIa antibody-producing B cells may be a predictor for TPO receptor agonists in patients with chronic liver disease.
Authors: M Kuwana; Y Kurata; K Fujimura; K Fujisawa; H Wada; T Nagasawa; S Nomura; T Kojima; H Yagi; Y Ikeda Journal: J Thromb Haemost Date: 2006-09 Impact factor: 5.824
Authors: Kelly M Grotzinger; Zobair M Younossi; Edoardo G Giannini; Pei-Jer Chen; Regina Rendas-Baum; Dickens Theodore Journal: Health Qual Life Outcomes Date: 2016-03-22 Impact factor: 3.186