A large observational study of patients with primary immune thrombocytopenia receiving romiplostim in European clinical practice

Eur J Haematol. 2017 Feb;98(2):112-120. doi: 10.1111/ejh.12807. Epub 2016 Sep 26.

Abstract

Objective: Romiplostim has maintained long-term platelet counts in patients with immune thrombocytopenia (ITP) for up to 5 yr in clinical studies. This prospective observational study aimed to describe romiplostim utilisation and outcomes in European clinical practice.

Methods: Adults with primary ITP who received romiplostim in routine care were eligible.

Results: Three-hundred and forty patients were eligible for analysis, of whom 299 (88%) completed the 2-yr observation period. The median age was 62 yr, with 43% of patients aged ≥65 yr, and two-thirds of patients initiated romiplostim before splenectomy. The median average weekly dose of romiplostim was 2.8 μg/kg. The median baseline platelet count was 20 × 109 /L, which increased after 2 wk of romiplostim treatment and remained >50 × 109 /L thereafter. After romiplostim initiation, there was a decrease in rates of grade ≥3 bleeding events (from 12 to 2 per 100 patient-years) and ITP-related hospitalisations (from 87 to 33 per 100 patient-years). The rate of thrombotic events was 2 per 100 patient-years, and bone marrow fibrosis occurred in two patients.

Conclusions: Romiplostim dosing, effectiveness and safety in an unselected real-world ITP population seemed comparable with that observed in clinical studies.

Keywords: observational research; platelet count; platelet disorders; primary immune thrombocytopenia; romiplostim; splenectomy.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Europe
  • Female
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Purpura, Thrombocytopenic, Idiopathic / surgery
  • Receptors, Fc / administration & dosage
  • Receptors, Fc / therapeutic use*
  • Recombinant Fusion Proteins / administration & dosage
  • Recombinant Fusion Proteins / adverse effects
  • Recombinant Fusion Proteins / therapeutic use*
  • Splenectomy
  • Thrombopoietin / administration & dosage
  • Thrombopoietin / adverse effects
  • Thrombopoietin / therapeutic use*
  • Treatment Outcome

Substances

  • Receptors, Fc
  • Recombinant Fusion Proteins
  • Thrombopoietin
  • romiplostim