Published online Dec 14, 2018. doi: 10.3748/wjg.v24.i46.5271
Peer-review started: September 12, 2018
First decision: October 14, 2018
Revised: October 20, 2018
Accepted: November 9, 2018
Article in press: November 9, 2018
Published online: December 14, 2018
To assess the correlation between the efficacy of lusutrombopag and clinical characteristics in patients with chronic liver disease.
In this retrospective, multicenter study, which conducted at four locations in Japan, 50 thrombocytopenic patients with chronic liver disease were enrolled. All patients received oral lusutrombopag (3.0 mg/d for 7 d) for chronic liver disease. We assessed the increase in platelet count after the trial drug administration. A treatment response was defined as a platelet count ≥ 5 × 104/μL and an increased platelet count ≥ 2 × 104/μL from baseline after drug administration. We evaluated the response to lusutrombopag compared to baseline clinical characteristics in patients with chronic liver disease.
The numbers of responders and non-responders were 40 (80.0%) and 10 (20.0%), respectively. The patients were divided into a responder and non-responder group, and we added factors that may correspond to successful treatment with lusutrombopag. Splenic volume and body weight were lower in the responder group than in the non-responder group. White blood cell count and hemoglobin level were higher in responders compared with non-responders. Using a logistic regression model to assess the relationship between response to lusutrombopag and clinical characteristics, multivariate analysis confirmed that splenic volume was an independent factor that predicted the response of platelet counts (P = 0.025; odds ratio = 11.2; 95% confidence interval: 1.354-103.0). Splenic volume negatively correlated to changes in platelet count (r = -0.524, P = 0.001).
Splenic volume influences the change in platelet counts after administration of lusutrombopag in patients with chronic liver disease.
Core tip: Lusutrombopag is an oral, small-molecule thrombopoietin receptor agonist used for the treatment of thrombocytopenic patients with chronic liver diseases. However, the response to this drug is unpredictable. The study aimed to assess the correlation between the clinical characteristics of patients with chronic liver disease and the efficacy of lusutrombopag treatment. Splenic volume influences the change in platelet counts after administration of lusutrombopag in patients with chronic liver disease. Splenic volume increase is negatively related to changes in the platelet count.