PMID- 37800793
OWN - NLM
STAT- MEDLINE
DCOM- 20231027
LR  - 20231107
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 40
DP  - 2023 Oct 6
TI  - Real-world use of avatrombopag in patients with chronic liver disease and 
      thrombocytopenia undergoing a procedure.
PG  - e35208
LID - 10.1097/MD.0000000000035208 [doi]
LID - e35208
AB  - The phase 4 observational cohort study assessed the effectiveness and safety of 
      the thrombopoietin receptor agonist avatrombopag in patients with chronic liver 
      disease (CLD) and thrombocytopenia undergoing a procedure. Patients with CLD may 
      have thrombocytopenia, increasing the risk of periprocedural bleeding. 
      Prophylactic platelet transfusions used to reduce this risk have limitations 
      including lack of efficacy and transfusion-associated reactions. Prophylactic 
      thrombopoietin receptor agonists have been shown to increase platelet counts and 
      decrease platelet transfusions. Effectiveness was assessed by change from 
      baseline in platelet count and proportion of patients needing a platelet 
      transfusion. Safety was assessed by monitoring adverse events (AEs). Of 50 
      patients enrolled, 48 were unique patients and 2 patients were enrolled twice for 
      separate procedures. The mean (standard deviation) change in platelet count from 
      baseline to procedure day was 41.1 x 109/L (33.29 x 109/L, n = 38), returning to 
      near baseline at the post-procedure visit (change from baseline -1.9 x 109/L 
      [15.03 x 109/L], n = 11). The proportion of patients not requiring a platelet 
      transfusion after baseline and up to 7 days following the procedure was 98% 
      (n = 49). Serious AEs were infrequent (n = 2 [4%]). No treatment-emergent AEs 
      were considered related to avatrombopag. There were 2 mild bleeding events, no 
      thromboembolic events or deaths, and no patients received rescue procedures 
      (excluding transfusions). This study found that in a real-world setting, 
      treatment with avatrombopag was well tolerated, increased the mean platelet count 
      by procedure day, and reduced the need for intraoperative platelet transfusions 
      in patients with CLD and thrombocytopenia.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Satapathy, Sanjaya K
AU  - Satapathy SK
AUID- ORCID: 0000-0003-0153-2829
AD  - North Shore University Hospital, Northwell Health, Manhasset, NY.
AD  - Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, 
      Hempstead, NY.
FAU - Sundaram, Vinay
AU  - Sundaram V
AD  - Division of Gastroenterology and Comprehensive Transplant Center, Cedars-Sinai 
      Medical Center, Los Angeles, CA.
FAU - Shiffman, Mitchell L
AU  - Shiffman ML
AD  - Liver Institute of Virginia, Liver Institute of Richmond, Liver Institute of 
      Hampton Roads, Bon Secours Mercy Health, Richmond and Newport News, VA.
FAU - Jamieson, Brian D
AU  - Jamieson BD
AD  - Sobi, Inc., Durham, NC.
LA  - eng
PT  - Clinical Trial, Phase IV
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 3H8GSZ4SQL (avatrombopag)
RN  - 0 (Receptors, Thrombopoietin)
SB  - IM
MH  - Humans
MH  - *Anemia
MH  - *Liver Diseases/complications
MH  - Platelet Count
MH  - Receptors, Thrombopoietin/agonists
MH  - *Thrombocytopenia/drug therapy
PMC - PMC10553023
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/10/06 12:42
MHDA- 2023/10/26 06:42
PMCR- 2023/10/06
CRDT- 2023/10/06 08:24
PHST- 2023/10/26 06:42 [medline]
PHST- 2023/10/06 12:42 [pubmed]
PHST- 2023/10/06 08:24 [entrez]
PHST- 2023/10/06 00:00 [pmc-release]
AID - 00005792-202310060-00044 [pii]
AID - 10.1097/MD.0000000000035208 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Oct 6;102(40):e35208. doi: 
      10.1097/MD.0000000000035208.