Department of Rheumatology and Immunology, 74723The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Sci Prog. 2022 Apr-Jun;105(2):368504221102786. doi: 10.1177/00368504221102786.
Eltrombopag, a kind of thrombopoietin (TPO) receptor agonist, plays the role on the megakaryocyte to activate the platelet production and rapidly increase the number of circulating platelets in patients with primary immune thrombocytopenia (ITP). Eltrombopag provides an opportunity for rapid tapering and/or cessation of corticosteroid therapy. However, it is not clear about the platelet response to Eltrombopag in ITP associated with Sjögren's Syndrome(SS).
A retrospective research was conducted on the clinical course of three patients, each with ITP secondary to SS, and initially received therapy of corticosteroids or other immunomodulatory. They took this drug for bleeding diseases. Referring to the description, Eltrombopag was prescribed and adjusted with an initial dose of 25 mg daily, then weekly, then monthly according to the monitoring of platelet counts.
All patients maintained a satisfactory level of platelet counts (>100,000/mm for >2 years) following corticosteroid withdrawal. Meanwhile, Eltrombopag was well-tolerated, and there were no adverse effects, such as thrombotic events.
Eltrombopag is effective and safe for patients with ITP associated with SS during corticosteroid withdrawal. Thus it may be a crucial therapeutic strategy for reducing corticosteroid-related side effects in SS patients with ITP.
艾曲波帕，一种血小板生成素（TPO）受体激动剂，在巨核细胞上发挥作用，激活血小板生成，并迅速增加原发性免疫性血小板减少症（ITP）患者循环血小板的数量。艾曲波帕为迅速减少和/或停止皮质类固醇治疗提供了机会。然而，关于艾曲波帕在干燥综合征（SS）相关 ITP 中的血小板反应尚不清楚。
对 3 例继发于 SS 的 ITP 患者的临床过程进行回顾性研究，每位患者最初均接受皮质类固醇或其他免疫调节剂治疗出血性疾病。参考描述，给予艾曲波帕治疗，并根据血小板计数监测情况，初始剂量为每天 25mg，然后每周一次，然后每月一次调整剂量。
所有患者在停用皮质类固醇后血小板计数维持在满意水平（>100,000/mm3 >2 年）。同时，艾曲波帕耐受良好，无血栓形成等不良反应。
对于 SS 相关 ITP 患者在停用皮质类固醇期间，艾曲波帕是有效且安全的。因此，它可能是减少 SS 相关 ITP 患者皮质类固醇相关副作用的重要治疗策略。
