Thrombocytopenia in liver disease

Section editors
	Shruti Chaturvedi, MBBS, MSCI Baltimore, MD LinkedIn		Benjamin Tillman, MD Nashville, TN

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

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Regimen

FDA-recommended dose

Study	Evidence	Comparator	Efficacy
Terrault et al. 2018 (ADAPT-1/ADAPT-2)	Phase III (E)	Placebo	Superior primary endpoint

Therapy

• Avatrombopag (Doptelet) as follows:
  • Platelet count less than 40 x 10⁹/L: 60 mg PO once per day on days 1 to 5
  • Platelet count at least 40 and less than 50 x 10⁹/L: 40 mg PO once per day on days 1 to 5

Procedure days were days 10 to 13

References

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 May 17. [Epub ahead of print] link to SD article PubMed