title: Is there a role for low-dose eltrombopag as maintenance therapy in the treatment of immune thrombocytopenia?
abstract: OBJECTIVE
  Thrombopoietin receptor agonists (romiplostim and eltrombopag) have recently been licensed for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenia (ITP) with an insufficient response to corticosteroids, immunoglobulins or splenectomy. In the present case series, we present 4 nonresponding patients with chronic ITP who achieved maintenance of complete response (CR) for a period of at least 6 months on eltrombopag treatment administered in a modified regimen of 25 mg for 2, 3 or 5 days a week.
  
  
  METHODS
  The present study is a retrospective, nonconsecutive case series of 4 eltrombopag-treated patients with chronic ITP. Secondary ITP had been excluded in each patient, first-line therapy had failed and splenectomy had been refused. Furthermore, each patient was treated with eltrombopag, which resulted in a CR for a mean of 2 months. Consequently, decreased eltrombopag dosages have been able to maintain long-term CR.
  
  
  CONCLUSIONS
  Despite the low quality of evidence, our study results support the use of reduced-dose eltrombopag as a maintenance therapy after achieving CR. It seems a very promising strategy for the effective maintenance of response, improving health-related quality of life, lowering costs and possibly improving the safety in the treatment of ITP.
authors.affiliation: Hematological Laboratory, Second Department of Internal Medicine, General Hospital Hippokrateon, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Efthymia
authors.initials: E
authors.lastname: Vlachaki
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sousos
authors.forename: Vasilios
authors.initials: V
authors.lastname: Perifanis
authors.forename: Georgia
authors.initials: G
authors.lastname: Kaiafa
authors.forename: Ilias
authors.initials: I
authors.lastname: Onoufriadis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Hatzitolios
authors.forename: Panagiota
authors.initials: P
authors.lastname: Boura
mesh_terms: D000328:Adult; D000368:Aged; D001565:Benzoates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006834:Hydrazines / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D011720:Pyrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D001565:Benzoates; D006834:Hydrazines; D011720:Pyrazoles; C520809:eltrombopag