Side effects of taking eltrombopag/eltrombopag

Eltrombopag/Eltrombopag is a second-line treatment drug (ITP) for refractory thrombocytopenia caused by immune thrombocytopenic purpura. The drug is generally well tolerated but can cause adverse thromboembolic complications in rare cases.

Eltrombopag is an oral thrombopoietin receptor agonist (TPO-RA) used to treat ITP, which is ineffective against steroids, immunosuppressants, and splenectomy if the risk of bleeding is increased. However, various studies have reported an increased risk of arterial and venous thrombosis associated with the use of eltrombopag. Studies have demonstrated that deep vein thrombosis, pulmonary embolism, portal vein thrombosis (PVT), extensive cerebral venous sinus thrombosis, ischemic stroke and myocardial infarction are part of the prothrombotic effects caused by the use of TPO-RAs. In one study, thromboembolic events recorded during three years of follow-up exceeded those experienced by the general population, affecting 5% of patients. In a disproportionality analysis, the median time from first TPO-RA exposure to thrombosis was recorded as 76.6 days.

The target platelet count in patients receiving eltrombopag should be 30-50k/μL, which is the optimal balance between bleeding risk and thrombotic risk. A platelet count of 50k/μL at any point during treatment is considered a good response to eltrombopag, and according to the study, this can usually be achieved within two weeks. For outpatient clinical practice, the primary goal is to monitor platelet counts until a stable count is achieved to prevent the development of blood clots. For eltrombopag, it is recommended to set a platelet count target of 50k/μL, reduce the dose when the platelet count is above 150k/μL, and discontinue treatment if the platelet count is above 250k/μL.