Impact of Anti-GPIIb/IIIa Antibody-Producing B Cells as a Predictor of the Response to Lusutrombopag in Thrombocytopenic Patients with Liver Disease.
Aged
Aged, 80 and over
Autoantibodies
/ biosynthesis
B-Lymphocytes
/ immunology
Blood Platelets
/ pathology
Cinnamates
/ administration & dosage
Female
Humans
Liver Diseases
/ blood
Male
Middle Aged
Multivariate Analysis
Organ Size
Platelet Count
Platelet Glycoprotein GPIIb-IIIa Complex
/ immunology
Prospective Studies
Spleen
/ pathology
Thiazoles
/ administration & dosage
Thrombocytopenia
/ blood
Anti-GPIIb/IIIa antibody-producing B cells
Chronic liver disease
Lusutrombopag
Thrombocytopenia
Thrombopoietin receptor agonist
Journal
Digestive diseases (Basel, Switzerland)
ISSN: 1421-9875
Titre abrégé: Dig Dis
Pays: Switzerland
ID NLM: 8701186
Informations de publication
Date de publication:
2021
2021
Historique:
received:
09
05
2020
accepted:
15
07
2020
pubmed:
8
8
2020
medline:
22
5
2021
entrez:
8
8
2020
Statut:
ppublish
Résumé
To make an accurate estimate of the response to thrombopoietin (TPO) receptor agonists for thrombocytopenia associated with chronic liver disease, we evaluated the influence of antiplatelet autoantibodies on the response to lusutrombopag in thrombocytopenic patients with liver disease. A prospective study was conducted at 2 hospitals. Thrombocytopenic patients with liver disease received oral lusutrombopag 3.0 mg once daily for up to 7 days. We analyzed changes in platelet counts from baseline to the maximum platelet count on days 9-14. The definition of clinical response was a platelet count of ≥5 × 104/μL with an increased platelet count of ≥2 × 104/μL from baseline. We assessed the correlation between the response to treatment drug and antiplatelet autoantibodies measured by anti-GPIIb/IIIa antibody-producing B cells. Thirty patients received the trial drug. There were 25 responders and 5 nonresponders. The median change in platelet counts was 3.9 × 104/μL (95% CI 2.8-4.6, p < 0.0001). The correlation between change in platelet counts and the frequency of the anti-glycoprotein IIb/IIIa antibody-producing B cells was moderate (r = 0.414, 95% CI 0.064-0.674, p = 0.023). In multivariate analysis of factors affecting the change in platelet counts, the anti-GPIIb/IIIa antibody-producing B cells were identified as an independent factor (regression coefficient [B] = 0.089; CI 0.021-0.157, p = 0.013). Anti-GPIIb/IIIa antibody-producing B cells may be a predictor for TPO receptor agonists in patients with chronic liver disease.
Sections du résumé
BACKGROUND
BACKGROUND
To make an accurate estimate of the response to thrombopoietin (TPO) receptor agonists for thrombocytopenia associated with chronic liver disease, we evaluated the influence of antiplatelet autoantibodies on the response to lusutrombopag in thrombocytopenic patients with liver disease.
METHODS
METHODS
A prospective study was conducted at 2 hospitals. Thrombocytopenic patients with liver disease received oral lusutrombopag 3.0 mg once daily for up to 7 days. We analyzed changes in platelet counts from baseline to the maximum platelet count on days 9-14. The definition of clinical response was a platelet count of ≥5 × 104/μL with an increased platelet count of ≥2 × 104/μL from baseline. We assessed the correlation between the response to treatment drug and antiplatelet autoantibodies measured by anti-GPIIb/IIIa antibody-producing B cells.
RESULTS
RESULTS
Thirty patients received the trial drug. There were 25 responders and 5 nonresponders. The median change in platelet counts was 3.9 × 104/μL (95% CI 2.8-4.6, p < 0.0001). The correlation between change in platelet counts and the frequency of the anti-glycoprotein IIb/IIIa antibody-producing B cells was moderate (r = 0.414, 95% CI 0.064-0.674, p = 0.023). In multivariate analysis of factors affecting the change in platelet counts, the anti-GPIIb/IIIa antibody-producing B cells were identified as an independent factor (regression coefficient [B] = 0.089; CI 0.021-0.157, p = 0.013).
CONCLUSION
CONCLUSIONS
Anti-GPIIb/IIIa antibody-producing B cells may be a predictor for TPO receptor agonists in patients with chronic liver disease.
Identifiants
pubmed: 32759604
pii: 000510692
doi: 10.1159/000510692
pmc: PMC8220915
doi:
Substances chimiques
Autoantibodies
0
Cinnamates
0
Platelet Glycoprotein GPIIb-IIIa Complex
0
Thiazoles
0
lusutrombopag
6LL5JFU42F
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
234-242Informations de copyright
© 2020 The Author(s). Published by S. Karger AG, Basel.
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