Multicenter, prospective study to evaluate the efficacy of biweekly romiplostim administration in patients with immune thrombocytopenia.
Multicenter, prospective study was conducted to evaluate the efficacy of biweekly romiplostim in maintaining platelet ≥ 30 × 10(9)/L for at least 4 weeks. Treatment was started with a weekly injection (1 mcg/kg), and the dose was escalated until a titrated dose was achieved that maintained a platelet 50-200 × 10(9)/L for four consecutive weeks. Patients were scheduled to a biweekly schedule, and returned to a weekly schedule if platelets fell to <30 × 10(9)/L. Eighteen patients were enrolled (median platelet, 14 × 10(9)/L). After the first weekly schedule, ten of eighteen (55.6 %) attained a median titrated dose of 3 mcg/kg and proceeded to the first biweekly schedule. However, all failed to maintain a platelet ≥ 30 × 10(9)/L for at least 4 weeks, and returned to a second weekly schedule, where eight of the ten achieved a titrated dose (median, 5 mcg/kg) and moved to a second schedule of biweekly romiplostim. Three of the eight (37.5 %) showed platelet ≥ 30 × 10(9)/L for 4, 8, and 10 weeks, but all eight patients eventually experienced a drop in platelets. Lengthening the dose interval of romiplostim to greater than a week is not feasible to maintain stable platelet count.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
Silvia
S
Park
Seoul National University Hospital, Seoul, Korea.
Sung Soo
SS
Yoon
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jung Hee
JH
Lee
Ajou University Hospital, Suwon, Korea.
Joon Seong
JS
Park
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea. smcjunhojang@gmail.com.
Jun Ho
JH
Jang
Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea. jwlee@catholic.ac.kr.
Jong Wook
JW
Lee
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D011961:Receptors, Fc / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D013921:Thrombocytopenia / Q000097:blood / Q000188:drug therapy*; D013926:Thrombopoietin / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim
Biweekly schedule; Immune thrombocytopenia; Romiplostim