title: Thrombopoietin Receptor Agonists Are Often Ineffective in Immune Thrombocytopenia and/or Cause Adverse Reactions: Results from One Hand.
abstract: BACKGROUND
  Eltrombopag and romiplostim are thrombopoietin receptor agonists (TPOs) that have been increasingly used for the treatment of immune thrombocytopenia (ITP). Based on our experience, the incidence of abortive treatment with these drugs and the occurrence of adverse reactions that lead to therapy break-off despite response are higher than has been previously suggested.
  
  
  METHODS
  During the last 8 years, a total of 65 patients were treated with eltrombopag and/or romiplostim at our institute.
  
  
  RESULTS
  36 of a total of 58 patients responded well to eltrombopag. In 12 patients that responded, treatment with eltrombopag was discontinued due to the development of adverse reactions. Eltrombopag was replaced by romiplostim in 23 cases (14 non-responders, 9 patients with adverse reactions). Of these patients, 83% responded to romiplostim. Among all patients treated with romiplostim (n = 32), 75% initially responded; however, 8 of these patients developed adverse reactions. Romiplostim was replaced by eltrombopag in 5 cases (4 due to adverse reactions, 1 non-responsive patient), and only 3 (60%) of these patients were observed to respond to eltrombopag.
  
  
  CONCLUSIONS
  TPOs often remain ineffective in ITP or result in adverse reactions, which lead to treatment stop or to drug switch. Therefore, alternative treatment options are required.
authors: Institute for Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Fabian
authors: F
authors: Depré
authors: Institute for Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Nasra
authors: N
authors: Aboud
authors: Institute for Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Frauke
authors: F
authors: Ringel
authors: Institute for Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: Abdulgabar
authors: A
authors: Salama
keywords: Adverse reactions; Autoimmune thrombocytopenia; Eltrombopag; Romiplostim; Thrombopoietin receptor agonists