Saudi Journal of Gastroenterology
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Year : 2010  |  Volume : 16  |  Issue : 1  |  Page : 51-56

Considerations in the management of hepatitis C virus-related thrombocytopenia with eltrombopag

1 Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom
2 Department of Medicine (Unit-I), Pakistan Institute of Medical Sciences, Islamabad, Pakistan
3 Department of Pediatrics, Holy Family Hospital, Rawalpindi, Pakistan
4 Foundation University Medical College, Rawalpindi, Pakistan
5 Department of Surgery (Unit-II), Rawalpindi General Hospital, Rawalpindi, Pakistan

Correspondence Address:
Fazal A Danish
Princess of Wales Hospital, Coity Road, Bridgend CF31 1RQ
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.58772

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Thrombocytopenia is a common clinical problem in HCV-infected cases. Multiple studies have consistently shown a rise in platelet count following a successful HCV treatment thus proving a cause-effect relationship between the two. Although, many therapeutic strategies have been tried in the past to treat HCV-related thrombocytopenia (e.g. interferon dose reductions, oral steroids, intravenous immunoglobulins, splenectomy etc), the success rates have been variable and not always reproducible. After the cessation of clinical trials of PEG-rHuMGDF due to immunogenecity issues, the introduction of non-immunogenic second-generation thrombopoietin-mimetics (eltrombopag and Romiplostim) has opened up a novel way to treat HCV-related thrombocytopenia. Although the data is still sparse, eltrombopag therapy has shown to successfully achieve the primary endpoint platelet counts of ≥50,000/μL in phase II& III, randomized, double-blind, placebo-controlled trials. Likewise, though it is premature to claim safety of this drug especially in high-risk patient groups, reported side effects in the published literature were of insufficient severity to require discontinuation of the drug. Based on the current and emerging evidence, a review of the pharmacologic basis, pharmacokinetics, therapeutic efficacy, safety profile and future considerations of eltrombopag in the context of HCV-related thrombocytopenia is given in this article. A MEDLINE search was conducted (1990 to August 2009) using the search terms eltrombopag, HCV, thrombocytopenia.

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