Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure
Thrombocytopenia is one of the most frequent implications of liver cirrhosis. This condition, when present in the severe form [platelet count (PLT) less than 50 × 109/L] correlates, with an increased risk of bleeding during the main diagnostic-therapeutic procedures which cirrhotic patients usually...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Open Exploration
2023-08-01
|
| Series: | Exploration of Drug Science |
| Subjects: | |
| Online Access: | https://www.explorationpub.com/uploads/Article/A100820/100820.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825199608975851520 |
|---|---|
| author | Davide Scalabrini Paolo Sciuto Cristina Felicani Antonia Rudilosso Pietro Andreone |
| author_facet | Davide Scalabrini Paolo Sciuto Cristina Felicani Antonia Rudilosso Pietro Andreone |
| author_sort | Davide Scalabrini |
| collection | DOAJ |
| description | Thrombocytopenia is one of the most frequent implications of liver cirrhosis. This condition, when present in the severe form [platelet count (PLT) less than 50 × 109/L] correlates, with an increased risk of bleeding during the main diagnostic-therapeutic procedures which cirrhotic patients usually undergone. In these cases, generally, an infusion of platelets is performed, albeit in recent years has been replaced by a cycle of second generation thrombopoietin receptor (TpoR) agonists. This article reports two different cases concerning respectively an 83-year-old female patient suffering from arterial hypertension, aneurysm of the sub-renal aorta, hepatitis C virus (HCV)-positive liver cirrhosis responsive to treatment with antiviral drugs, and a 2.0 cm diameter hepatocellular carcinoma (HCC) nodule localized in the hepatic segment III and a 53-year-old female patient with HCV-positive liver cirrhosis complicated by portal hypertension with splenomegaly, thrombocytopenia, and F3 esophageal varices at high risk of bleeding. Both of them, eligible for invasive procedures such as HCC transarterial chemoembolization (TACE) and for esophageal variceal band ligation, were prescribed prophylaxis with TpoR agonists due to their severe and persistent thrombocytopenia. These two cases show how a short course of lusutrombopag allows to safely perform one or more invasive procedures and how the administration of the drug can be repeated without losing efficacy. Furthermore, this drug shows an excellent safety profile and avoids the risks of platelet transfusion. In conclusion, second generation TpoR agonists can be considered the prophylactic treatment of choice to reduce the risk of bleeding in patients with liver cirrhosis and severe thrombocytopenia. |
| format | Article |
| id | doaj-art-c5effa84e8a44e6abe36b9a690bb1198 |
| institution | Kabale University |
| issn | 2836-7677 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Open Exploration |
| record_format | Article |
| series | Exploration of Drug Science |
| spelling | doaj-art-c5effa84e8a44e6abe36b9a690bb11982025-02-08T03:49:04ZengOpen ExplorationExploration of Drug Science2836-76772023-08-011429229810.37349/eds.2023.00020Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedureDavide Scalabrini0https://orcid.org/0000-0001-8590-6757Paolo Sciuto1Cristina Felicani2https://orcid.org/0000-0002-3842-4701Antonia Rudilosso3Pietro Andreone4https://orcid.org/0000-0002-4794-9809U.O. di Medicina Interna Metabolica Nutrizionale, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, ItalyU.O. di Medicina Interna Metabolica Nutrizionale, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, ItalyU.O. di Medicina Interna Metabolica Nutrizionale, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, ItalyU.O. di Medicina Interna Metabolica Nutrizionale, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, ItalyU.O. di Medicina Interna Metabolica Nutrizionale, Azienda Ospedaliero Universitaria di Modena, 41124 Modena, Italy; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, ItalyThrombocytopenia is one of the most frequent implications of liver cirrhosis. This condition, when present in the severe form [platelet count (PLT) less than 50 × 109/L] correlates, with an increased risk of bleeding during the main diagnostic-therapeutic procedures which cirrhotic patients usually undergone. In these cases, generally, an infusion of platelets is performed, albeit in recent years has been replaced by a cycle of second generation thrombopoietin receptor (TpoR) agonists. This article reports two different cases concerning respectively an 83-year-old female patient suffering from arterial hypertension, aneurysm of the sub-renal aorta, hepatitis C virus (HCV)-positive liver cirrhosis responsive to treatment with antiviral drugs, and a 2.0 cm diameter hepatocellular carcinoma (HCC) nodule localized in the hepatic segment III and a 53-year-old female patient with HCV-positive liver cirrhosis complicated by portal hypertension with splenomegaly, thrombocytopenia, and F3 esophageal varices at high risk of bleeding. Both of them, eligible for invasive procedures such as HCC transarterial chemoembolization (TACE) and for esophageal variceal band ligation, were prescribed prophylaxis with TpoR agonists due to their severe and persistent thrombocytopenia. These two cases show how a short course of lusutrombopag allows to safely perform one or more invasive procedures and how the administration of the drug can be repeated without losing efficacy. Furthermore, this drug shows an excellent safety profile and avoids the risks of platelet transfusion. In conclusion, second generation TpoR agonists can be considered the prophylactic treatment of choice to reduce the risk of bleeding in patients with liver cirrhosis and severe thrombocytopenia.https://www.explorationpub.com/uploads/Article/A100820/100820.pdfthrombocytopeniacirrhosisthrombopoietin receptor agonistslusutrombopag |
| spellingShingle | Davide Scalabrini Paolo Sciuto Cristina Felicani Antonia Rudilosso Pietro Andreone Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure Exploration of Drug Science thrombocytopenia cirrhosis thrombopoietin receptor agonists lusutrombopag |
| title | Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| title_full | Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| title_fullStr | Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| title_full_unstemmed | Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| title_short | Single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| title_sort | single or multiple treatments with lusutrombopag in subjects with thrombocytopenia and chronic liver disease needing an invasive procedure |
| topic | thrombocytopenia cirrhosis thrombopoietin receptor agonists lusutrombopag |
| url | https://www.explorationpub.com/uploads/Article/A100820/100820.pdf |
| work_keys_str_mv | AT davidescalabrini singleormultipletreatmentswithlusutrombopaginsubjectswiththrombocytopeniaandchronicliverdiseaseneedinganinvasiveprocedure AT paolosciuto singleormultipletreatmentswithlusutrombopaginsubjectswiththrombocytopeniaandchronicliverdiseaseneedinganinvasiveprocedure AT cristinafelicani singleormultipletreatmentswithlusutrombopaginsubjectswiththrombocytopeniaandchronicliverdiseaseneedinganinvasiveprocedure AT antoniarudilosso singleormultipletreatmentswithlusutrombopaginsubjectswiththrombocytopeniaandchronicliverdiseaseneedinganinvasiveprocedure AT pietroandreone singleormultipletreatmentswithlusutrombopaginsubjectswiththrombocytopeniaandchronicliverdiseaseneedinganinvasiveprocedure |