Therapeutic effect of the combination of eltrombopag and low dose hormone in patients with primary immune thrombocytopenia

Abstract

Purpose: To investigate the clinical effect and side effects of early addition of small-dose eltrombopag in initial treatment of primary immune thrombocytopenia (ITP) patients with decreased platelet count and hormone reduction, and patients with persistent ITP. Methods: Thirty ITP patients newly diagnosed with poor hormonal levels were recruited, along with 36 patients with persistent ITP. The ITP patients were given prednisone in combination with eltrombopag. Blood routine tests, blood pressure, blood sugar, liver and kidney function, and serum ion levels were monitored every two weeks. Adverse events were recorded at 2, 4, and 8 weeks after eltrombopag treatment. Results: After treatment for 2, 4, and 8 weeks, there was obvious effectiveness in 45.0, 39.4, and 40.9 % of patients, respectively, while effectiveness was good in 22.7, 37.9, and 50 % of patients, respectively. Treatment was ineffective in 31.8, 22.7, and 9.1 % of patients, respectively. In the 8th week, 15 patients (22.7 %) had to use prednisone at a dose of more than 20 mg/day to keep their platelet level above 30 x 109/L, while 7 patients (10.6 %) stopped using prednisone completely. Moreover, 4 patients (6.1 %) had their platelet counts maintained above 30 x 109/L after stopping the use of eltrombopag for more than 2 weeks. Conclusion: The combined use of eltrombopag and low-dose hormone is an effective treatment for ITP patients. It produces only a slight side effect, and it is affordable. A larger population study will be required to validate these findings of this new therapeutic option.