Initial romiplostim dosing and time to platelet response in patients with treatment refractory immune thrombocytopenia

摘要

Background/rationale Romiplostim is a thrombopoietin receptor agonist recommended as a second-line therapy for immune thrombocytopenia. An initial dose of 1?mcg/kg/week subcutaneously with weekly 1?mcg/kg dose escalation is recommended per package labeling. Optimizing romiplostim dosing for hospitalized, corticosteroid- and intravenous immunoglobulin-refractory patients with severe thrombocytopenia secondary to immune thrombocytopenia may be critical for improving platelet responses, reducing the risk of bleeding, and decreasing hospital length of stay. Limited data are available evaluating the efficacy and safety of higher initial doses. Objective The primary objective of this study was to compare the time to platelet?≥?10?×?10~(9)/L between patients who received an initial romiplostim dose of ≥2?mcg/kg/week compared to the standard initial dose of 1?mcg/kg/week. Secondary objectives included time to platelet response?≥?30?×?10~(9)/L and ≥50?×?10~(9)/L, percentage of patients achieving platelet responses, hospital length of stay, and incidence of adverse events and bleeding complications. Methods This was a retrospective, single-center, cohort study including hospitalized adults with corticosteroid- and intravenous immunoglobulin-refractory immune thrombocytopenia. A baseline platelet?