Romiplostim

EHA 2020: In an European clinical practice, the data showed that the use of Romiplostim was effective and safe in newly diagnosed ITP patients and in patients with persistent ITP.

EHA 2020 poster Taylor et al.

EHA scientific symposium in ITP:


scientific-symposium

Dec 2019: Updates of ITP Guidelines

ASH ITP Guidelines 2019 by Neunert C, et al. and ITP International Consensus Report 2019 by Provan D, et al.

ASH 2019: Real World Data of Romiplostim in patients with newly diagnosed ITP or persistent ITP.

This retrospective study with the pre/post cohort design showed the effectiveness of Romiplostim in patients that started Romiplostim therapy within 1 year of ITP diagnosis: the incidence of bleeding events, the use of emergency medication and hospitalisation related to ITP were evaluated before and after the start of Romiplostim therapy.

ASH 2019: Efficacy study results of Romiplostim in chemotherapy-induced thrombocytopenia (CIT) in cancer patients, including lymphoid malignancies.

In the cohort with 173 patients, romiplostim was highly effective in solid tumor patients with CIT, allowing chemotherapy administration. Bleeding and thrombosis rates were similar to the general cancer patient population. Both weekly and intracycle dosing were effective and equally safe, but weekly dosing maintained higher platelets overall and higher platelet nadirs with fewer chemotherapy dose reductions or treatment delays. Bone marrow invasion, pelvic irradiation, and prior temozolomide predicted romiplostim non-response. Romiplostim had modest effectiveness to manage CIT in lymphoid malignancy patients with underlying bone marrow involvement.
The abstract of the oral presentation by Al-Samkari H, et al. is shown here.

ASH 2019: Long term therapy with TPO-RA is predictive for Treatment Free Responses (TFR) in chronic ITP: a retrospective multicenter study

A multicenter retrospective study showed that with long therapy duration of TPO-RA (median of 3.3 years), half of the patients treated with Romiplostim and not undergoing switching, can achieve TFR.
Kaplan-Meier curve for the cumulative probability of TFR in patients with chronic ITP who received only Romiplostim (a), only Eltrombopag (b); switching from Romiplostim to Eltrombopag (c) and switching from Eltrombopag to Romiplostim (d)
The abstract of the poster presentation by Lozano ML, et al. is shown here.
The publication of the Real World Study by Lozano et al. is available as Open access.

ASH 2019: Influence of age on treatment with TPO-RA in patients with ITP: a retrospective multicenter study

The unfavorable medical conditions (vascular events) in the elder ITP population induces a preferential use of TPO-RAs, with a lower bleeding history than in younger patients. Although these drugs are associated with a potential risk of increased thrombotic events, the data of this retrospective study indicate that past thrombotic history does not predispose to the development of vascular events.
The abstract of the poster presentation by Lozano ML, et al. is shown here.

ASH 2019: Risk of complications for second-line treatments (TPO-RA versus Rituximab) of chronic Immune Thrombocytopenia in Veterans: A U.S. National Study. (Abstract 85)

Among cITP-diagnosed US Veterans (>31'000), 245 received TPO-RA and 185 Rituximab as 2L. With comparable baseline characteristics, TPO-RA use was associated with lower risks of complications compared to Rituximab (infections, risk of thromboembolic event). There was no observed difference in the risk of death between the groups.
The abstract of the poster presentation by Ruiz-Negron N, et al. is shown here.

ITP Assembly 2019 : the case presentations and discussions of the ITP expert meeting are available on

username: ITP2019
Password: Amsterdam

EHA 2019: upcoming ITP management guidelines

In ITP tapering and discontinuation of romiplostim and TPO-R agonists are relevant and will become part of the ITP management guidelines - ASH guidelines and International Consensus Report.
The ongoing revision of the international ITP guidelines was discussed in the ITP symposium. In ITP, tapering and discontinuation of romiplostim and TPO-R agonists are relevant and will become part of the ITP management guidelines. The slides are available here, and discussions can be accessed on www.amgeneducation.com (username: EHA2019; Password: Amsterdam).


EHA 2019: Safety and efficacy of Romiplostim in over 200 children with persistent or chronic Immune Thrombocytopenia in an integrated database of 5 clinical trials

EHA 2019: Results from a Spanish observational, retrospective, multicenter study with TPO-RA in ITP

patients concluded that there is no specific determinants (biological and clinical factors) that favor the use of specific TPO-RA, but that romiplostim seems to be a preferable option, when a rapid increase in platelets is desirable for ITP patients to avoid the risk of bleedings. Although no patient features seemed to consistently predict for sustained response of TPO-RA therapy, a multi-variate analysis showed that receiving romiplostim as first TPO-RA was positively associated with Therapy Free Responses (TFR).

ASCO 2019: Burden of Thrombocytopenia in adult cancer patients receiving chemotherapy: current snapshot of the CIT risk

in a large sample of cancer patients being treated in routine clinical practice in the US highlights patients at highest risk for CIT and the challenges treating physicians and their patients confront.

ASH 2018 : Predictors of remission in adults with ITP treated with Romiplostim

Predictors of remission in ITP wit Romiplostim
(Newland et al., ASH 2018)
In this Oral presentation A. Newland showed with an integrated analysis of 911 adult ITP patients across 13 studies that the treatment within 12 months of ITP diagnosis was an independent predictor of treatment-free remission (TFR). Prior splenectomy was not an independent predictor of TFR in this much larger analysis.
The results indicate that earlier use of romiplostim in adults with ITP could be associated with greater likelihood of achieving TFR ≥ 6-months.

This congress-section could contain information to non-licensed treatment lines, combinations and dosage regimens.

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