Eltrombopag for Thrombocytopenia in Patients with Cirrhosis Associated with Hepatitis C

• Published in: The New England journal of medicine Vol. 357; no. 22; pp. 2227 - 2236
• Main Authors: McHutchison, John G, Dusheiko, Geoffrey, Shiffman, Mitchell L, Rodriguez-Torres, Maribel, Sigal, Samuel, Bourliere, Marc, Berg, Thomas, Gordon, Stuart C, Campbell, Fiona M, Theodore, Dickens, Blackman, Nicole, Jenkins, Julian, Afdhal, Nezam H
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 29.11.2007
• Subjects: Adult; Aged; Antiviral Agents - therapeutic use; Benzoates - adverse effects; Benzoates - therapeutic use; Biological and medical sciences; Double-Blind Method; Female; General aspects; Headache - chemically induced; Hematologic and hematopoietic diseases; Hepatitis; Hepatitis C - complications; Hepatitis C - drug therapy; Humans; Hydrazines - adverse effects; Hydrazines - therapeutic use; Hypertension; Interferon-alpha - therapeutic use; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver diseases; Male; Medical sciences; Middle Aged; Platelet Count; Platelet diseases and coagulopathies; Polyethylene Glycols - therapeutic use; Pyrazoles - adverse effects; Pyrazoles - therapeutic use; Receptors, Thrombopoietin - agonists; Recombinant Proteins; Thrombocytopenia - blood; Thrombocytopenia - drug therapy; Thrombocytopenia - etiology; Human; Thrombocytopenia; Hepatic disease; Patient; Hemopathy; Infection; Medicine; Cirrhosis; Platelet; Association; Eltrombopag; Viral disease; Digestive diseases; Viral hepatitis C
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa073255

Eltrombopag, an orally active agonist of the thrombopoietin receptor, elevates platelet counts in normal subjects and in patients with immune thrombocytopenia (see the article by Bussell et al. in this issue of the Journal ). This preliminary trial tested the drug in patients with thrombocytopenia and cirrhosis associated with the hepatitis C virus. Eltrombopag was effective in raising the platelet count, thereby allowing for antiviral treatment for up to 12 weeks. Eltrombopag is an orally active agonist of the thrombopoietin receptor. This trial tested the drug in patients with thrombocytopenia and cirrhosis associated with the hepatitis C virus. Eltrombopag was effective in raising the platelet count, thereby allowing for antiviral treatment. Thrombocytopenia is a frequent complication of chronic liver disease and is considered an indicator of advanced disease. 1 – 3 The low platelet count is due partly to the effects of portal hypertension and hypersplenism, 4 decreased thrombopoietin production, 2 , 5 , 6 and virus-induced bone marrow suppression. 7 , 8 Patients with chronic liver disease due to infection with the hepatitis C virus (HCV) who have thrombocytopenia (<75,000 platelets per cubic millimeter) have been routinely excluded from clinical trials of interferon and ribavirin, and few published reports have described the treatment of chronic HCV infection in patients with platelet counts of less than 50,000 per cubic . . .