Difference between revisions of "Thrombocytopenia in liver disease"
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Warner-admin (talk | contribs) m (Text replacement - "!style="width: 25%"|Study !style="width: 25%"|Evidence !style="width: 25%"|Comparator !style="width: 25%"|Efficacy" to "!style="width: 25%"|Study !style="width: 25%"|Evidence !style="width: 25%"|Comparator !style="width: 25%"|Comparative Efficacy") |
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− | + | </div> | |
− | + | {{#lst:Editorial board transclusions|heme}} | |
− | + | ''Are you looking for a regimen, but can't find it here? For placebo or observational studies in this condition, please visit [[Thrombocytopenia in liver disease - null regimens|this page]]. If you still can't find it, please let us know so we can add it!''<br> | |
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See the [[Thrombocytopenia|thrombocytopenia reference page]] for general definitions and workup recommendations. | See the [[Thrombocytopenia|thrombocytopenia reference page]] for general definitions and workup recommendations. | ||
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{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
=Thrombocytopenia in liver disease with planned procedure= | =Thrombocytopenia in liver disease with planned procedure= | ||
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==Avatrombopag monotherapy {{#subobject:7c8c62|Regimen=1}}== | ==Avatrombopag monotherapy {{#subobject:7c8c62|Regimen=1}}== | ||
− | + | <div class="toccolours" style="background-color:#eeeeee"> | |
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===Regimen {{#subobject:666055|Variant=1}}=== | ===Regimen {{#subobject:666055|Variant=1}}=== | ||
{| class="wikitable" style="color:white; background-color:#404040" | {| class="wikitable" style="color:white; background-color:#404040" | ||
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− | {| class="wikitable" style="width: 100%; text-align:center;" | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
− | !style="width: | + | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !style="width: | + | !style="width: 20%"|Comparator |
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1053/j.gastro.2018.05.025 Terrault et al. 2018 (ADAPT-2)] | ||
+ | |2013-2017 | ||
+ | | style="background-color:#1a9851" |Phase 3 (E-esc) | ||
+ | |[[Thrombocytopenia_in_liver_disease_-_null_regimens#Placebo|Placebo]] | ||
+ | | style="background-color:#1a9850" |Superior primary endpoint | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1053/j.gastro.2018.05.025 Terrault et al. 2018 (ADAPT-1)] |
− | | style="background-color:#1a9851" |Phase | + | |2014-2017 |
− | |[[#Placebo|Placebo]] | + | | style="background-color:#1a9851" |Phase 3 (E-esc) |
+ | |[[Thrombocytopenia_in_liver_disease_-_null_regimens#Placebo|Placebo]] | ||
| style="background-color:#1a9850" |Superior primary endpoint | | style="background-color:#1a9850" |Superior primary endpoint | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Growth factor therapy==== | ====Growth factor therapy==== | ||
− | *[[Avatrombopag (Doptelet)]] | + | *[[Avatrombopag (Doptelet)]] by the following laboratory-based criteria: |
**Platelet count less than 40 x 10<sup>9</sup>/L: 60 mg PO once per day on days 1 to 5 | **Platelet count less than 40 x 10<sup>9</sup>/L: 60 mg PO once per day on days 1 to 5 | ||
− | **Platelet count | + | **Platelet count 40 up to 50 x 10<sup>9</sup>/L: 40 mg PO once per day on days 1 to 5 |
+ | '''Procedure days were days 10 to 13''' | ||
+ | </div></div> | ||
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===References=== | ===References=== | ||
− | # '''ADAPT-1 | + | # '''ADAPT-1:''' Terrault N, Chen YC, Izumi N, Kayali Z, Mitrut P, Tak WY, Allen LF, Hassanein T. Avatrombopag before procedures reduces need for platelet transfusion in patients with chronic liver disease and thrombocytopenia. Gastroenterology. 2018 Sep;155(3):705-718. Epub 2018 May 17. [https://doi.org/10.1053/j.gastro.2018.05.025 link to original article] [https://pubmed.ncbi.nlm.nih.gov/29778606/ PubMed] [https://clinicaltrials.gov/study/NCT01972529 NCT01972529] |
− | + | # '''ADAPT-2:''' Terrault N, Chen YC, Izumi N, Kayali Z, Mitrut P, Tak WY, Allen LF, Hassanein T. Avatrombopag before procedures reduces need for platelet transfusion in patients with chronic liver disease and thrombocytopenia. Gastroenterology. 2018 Sep;155(3):705-718. Epub 2018 May 17. [https://doi.org/10.1053/j.gastro.2018.05.025 link to original article] [https://pubmed.ncbi.nlm.nih.gov/29778606/ PubMed] [https://clinicaltrials.gov/study/NCT01976104 NCT01976104] | |
==Lusutrombopag monotherapy {{#subobject:8f4acd|Regimen=1}}== | ==Lusutrombopag monotherapy {{#subobject:8f4acd|Regimen=1}}== | ||
− | + | <div class="toccolours" style="background-color:#eeeeee"> | |
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===Regimen {{#subobject:4c9447|Variant=1}}=== | ===Regimen {{#subobject:4c9447|Variant=1}}=== | ||
{| class="wikitable" style="color:white; background-color:#404040" | {| class="wikitable" style="color:white; background-color:#404040" | ||
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|} | |} | ||
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
− | !style="width: | + | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !style="width: | + | !style="width: 20%"|Comparator |
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1016/j.cgh.2020.03.032 Alkhouri et al. 2020 (L-PLUS 1)] | ||
+ | |2013-10 to 2014-05 | ||
+ | | style="background-color:#1a9851" |Phase 3 (E-esc) | ||
+ | |[[Thrombocytopenia_in_liver_disease_-_null_regimens#Placebo|Placebo]] | ||
+ | | style="background-color:#1a9850" |Superior primary endpoint | ||
|- | |- | ||
− | |( | + | |[https://doi.org/10.1016/j.cgh.2020.03.032 Alkhouri et al. 2020 (L-PLUS 2)] |
− | | style="background-color:#1a9851" |Phase | + | |2015-2017 |
− | |[[#Placebo|Placebo]] | + | | style="background-color:#1a9851" |Phase 3 (E-esc) |
+ | |[[Thrombocytopenia_in_liver_disease_-_null_regimens#Placebo|Placebo]] | ||
| style="background-color:#1a9850" |Superior primary endpoint | | style="background-color:#1a9850" |Superior primary endpoint | ||
|- | |- | ||
|} | |} | ||
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
====Growth factor therapy==== | ====Growth factor therapy==== | ||
*[[Lusutrombopag (Mulpleta)]] 3 mg PO once per day on days 1 to 7 | *[[Lusutrombopag (Mulpleta)]] 3 mg PO once per day on days 1 to 7 | ||
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'''7-day course''' | '''7-day course''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # [https:// | + | # '''L-PLUS 1:''' Alkhouri N, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Trevisani F. Lusutrombopag Is Safe and Efficacious for Treatment of Thrombocytopenia in Patients With and Without Hepatocellular Carcinoma. Clin Gastroenterol Hepatol. 2020 Oct;18(11):2600-2608.e1. Epub 2020 Mar 20. [https://doi.org/10.1016/j.cgh.2020.03.032 link to original article] [https://pubmed.ncbi.nlm.nih.gov/32205226/ PubMed] JapicCTI-132323 |
− | + | # '''L-PLUS 2:''' Alkhouri N, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Trevisani F. Lusutrombopag Is Safe and Efficacious for Treatment of Thrombocytopenia in Patients With and Without Hepatocellular Carcinoma. Clin Gastroenterol Hepatol. 2020 Oct;18(11):2600-2608.e1. Epub 2020 Mar 20. [https://doi.org/10.1016/j.cgh.2020.03.032 link to original article] [https://pubmed.ncbi.nlm.nih.gov/32205226/ PubMed] [https://clinicaltrials.gov/study/NCT02389621 NCT02389621] | |
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[[Category:Thrombocytopenia in liver disease regimens]] | [[Category:Thrombocytopenia in liver disease regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Cytopenias]] | [[Category:Cytopenias]] |
Latest revision as of 23:56, 15 May 2024
Section editor | |
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Benjamin Tillman, MD Vanderbilt University Nashville, TN, USA |
Are you looking for a regimen, but can't find it here? For placebo or observational studies in this condition, please visit this page. If you still can't find it, please let us know so we can add it!
See the thrombocytopenia reference page for general definitions and workup recommendations.
2 regimens on this page
2 variants on this page
|
Thrombocytopenia in liver disease with planned procedure
Avatrombopag monotherapy
Regimen
FDA-recommended dose |
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Terrault et al. 2018 (ADAPT-2) | 2013-2017 | Phase 3 (E-esc) | Placebo | Superior primary endpoint |
Terrault et al. 2018 (ADAPT-1) | 2014-2017 | Phase 3 (E-esc) | Placebo | Superior primary endpoint |
Growth factor therapy
- Avatrombopag (Doptelet) by the following laboratory-based criteria:
- Platelet count less than 40 x 109/L: 60 mg PO once per day on days 1 to 5
- Platelet count 40 up to 50 x 109/L: 40 mg PO once per day on days 1 to 5
Procedure days were days 10 to 13
References
- ADAPT-1: Terrault N, Chen YC, Izumi N, Kayali Z, Mitrut P, Tak WY, Allen LF, Hassanein T. Avatrombopag before procedures reduces need for platelet transfusion in patients with chronic liver disease and thrombocytopenia. Gastroenterology. 2018 Sep;155(3):705-718. Epub 2018 May 17. link to original article PubMed NCT01972529
- ADAPT-2: Terrault N, Chen YC, Izumi N, Kayali Z, Mitrut P, Tak WY, Allen LF, Hassanein T. Avatrombopag before procedures reduces need for platelet transfusion in patients with chronic liver disease and thrombocytopenia. Gastroenterology. 2018 Sep;155(3):705-718. Epub 2018 May 17. link to original article PubMed NCT01976104
Lusutrombopag monotherapy
Regimen
FDA-recommended dose |
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Alkhouri et al. 2020 (L-PLUS 1) | 2013-10 to 2014-05 | Phase 3 (E-esc) | Placebo | Superior primary endpoint |
Alkhouri et al. 2020 (L-PLUS 2) | 2015-2017 | Phase 3 (E-esc) | Placebo | Superior primary endpoint |
References
- L-PLUS 1: Alkhouri N, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Trevisani F. Lusutrombopag Is Safe and Efficacious for Treatment of Thrombocytopenia in Patients With and Without Hepatocellular Carcinoma. Clin Gastroenterol Hepatol. 2020 Oct;18(11):2600-2608.e1. Epub 2020 Mar 20. link to original article PubMed JapicCTI-132323
- L-PLUS 2: Alkhouri N, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Trevisani F. Lusutrombopag Is Safe and Efficacious for Treatment of Thrombocytopenia in Patients With and Without Hepatocellular Carcinoma. Clin Gastroenterol Hepatol. 2020 Oct;18(11):2600-2608.e1. Epub 2020 Mar 20. link to original article PubMed NCT02389621