Use of thrombopoietin receptor agonists ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
Permalink :
Title :
Use of thrombopoietin receptor agonists for immune thrombocytopenia in pregnancy: results from a multicenter study
Author(s) :
Michel, Marc [Auteur]
CHU Henri Mondor [Créteil]
Ruggeri, Marco [Auteur]
Gonzalez-Lopez, Tomas Jose [Auteur]
Universidad de Burgos
Alkindi, Salam S. [Auteur]
Sultan Qaboos University [SQU]
Cheze, Stephane [Auteur]
Institut d'Hématologie de Basse-Normandie [IHBN]
Ghanima, Waleed [Auteur]
University of Oslo [UiO]
Tvedt, Tor Henrik Anderson [Auteur]
University of Bergen [UiB]
Ebbo, Mikael [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Terriou, Louis [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bussel, James B. [Auteur]
Weill Cornell Medicine [Qatar]
Godeau, Bertrand [Auteur]
Centre d'Investigation Clinique Henri Mondor [CIC Henri Mondor]
CHU Henri Mondor [Créteil]
Ruggeri, Marco [Auteur]
Gonzalez-Lopez, Tomas Jose [Auteur]
Universidad de Burgos
Alkindi, Salam S. [Auteur]
Sultan Qaboos University [SQU]
Cheze, Stephane [Auteur]
Institut d'Hématologie de Basse-Normandie [IHBN]
Ghanima, Waleed [Auteur]
University of Oslo [UiO]
Tvedt, Tor Henrik Anderson [Auteur]
University of Bergen [UiB]
Ebbo, Mikael [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Terriou, Louis [Auteur]

Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bussel, James B. [Auteur]
Weill Cornell Medicine [Qatar]
Godeau, Bertrand [Auteur]
Centre d'Investigation Clinique Henri Mondor [CIC Henri Mondor]
Journal title :
Blood
Abbreviated title :
Blood
Publication date :
2020-08-19
ISSN :
1528-0020
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Management of immune thrombocytopenia (ITP) during pregnancy can be challenging because treatment choices are limited. Thrombopoietin receptor agonists (Tpo-RAs), which likely cross the placenta, are not recommended during ...
Show more >Management of immune thrombocytopenia (ITP) during pregnancy can be challenging because treatment choices are limited. Thrombopoietin receptor agonists (Tpo-RAs), which likely cross the placenta, are not recommended during pregnancy. To better assess the safety and efficacy of off-label use of Tpo-RAs during pregnancy, a multicenter observational and retrospective study was conducted. Results from 15 pregnant women with ITP (pregnancies, n = 17; neonates, n = 18) treated with either eltrombopag (n = 8) or romiplostim (n = 7) during pregnancy, including 2 patients with secondary ITP, were analyzed. Median time of Tpo-RA exposure during pregnancy was 4.4 weeks (range, 1-39 weeks); the indication for starting Tpo-RAs was preparation for delivery in 10 (58%) of 17 pregnancies, whereas 4 had chronic refractory symptomatic ITP and 3 were receiving eltrombopag when pregnancy started. Regarding safety, neither thromboembolic events among mothers nor Tpo-RA-related fetal or neonatal complications were observed, except for 1 case of neonatal thrombocytosis. Response to Tpo-RAs was achieved in 77% of cases, mostly in combination with concomitant ITP therapy (70% of responders). On the basis of these preliminary findings, temporary off-label use of Tpo-RAs for severe and/or refractory ITP during pregnancy seems safe for both mother and neonate and is likely to be helpful, especially before delivery.Show less >
Show more >Management of immune thrombocytopenia (ITP) during pregnancy can be challenging because treatment choices are limited. Thrombopoietin receptor agonists (Tpo-RAs), which likely cross the placenta, are not recommended during pregnancy. To better assess the safety and efficacy of off-label use of Tpo-RAs during pregnancy, a multicenter observational and retrospective study was conducted. Results from 15 pregnant women with ITP (pregnancies, n = 17; neonates, n = 18) treated with either eltrombopag (n = 8) or romiplostim (n = 7) during pregnancy, including 2 patients with secondary ITP, were analyzed. Median time of Tpo-RA exposure during pregnancy was 4.4 weeks (range, 1-39 weeks); the indication for starting Tpo-RAs was preparation for delivery in 10 (58%) of 17 pregnancies, whereas 4 had chronic refractory symptomatic ITP and 3 were receiving eltrombopag when pregnancy started. Regarding safety, neither thromboembolic events among mothers nor Tpo-RA-related fetal or neonatal complications were observed, except for 1 case of neonatal thrombocytosis. Response to Tpo-RAs was achieved in 77% of cases, mostly in combination with concomitant ITP therapy (70% of responders). On the basis of these preliminary findings, temporary off-label use of Tpo-RAs for severe and/or refractory ITP during pregnancy seems safe for both mother and neonate and is likely to be helpful, especially before delivery.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Submission date :
2021-07-06T12:45:53Z
2024-01-26T13:07:01Z
2024-01-26T13:07:01Z