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. 2019 May;102(5):416-423.
doi: 10.1111/ejh.13221. Epub 2019 Mar 7.

Primary immune thrombocytopenia (ITP) treated with romiplostim in routine clinical practice: retrospective study from the United Kingdom ITP Registry

Indraraj Umesh Doobaree  1 , Adrian Newland  1 , Vickie McDonald  1 , Raghava Nandigam  1 , Lesley Mensah  2 , Sandrine Leroy  3 , Anouchka Seesaghur  3 , Hitan Patel  4 , Sally Wetten  2 , Drew Provan  1
Affiliations

Primary immune thrombocytopenia (ITP) treated with romiplostim in routine clinical practice: retrospective study from the United Kingdom ITP Registry

Indraraj Umesh Doobaree et al. Eur J Haematol. 2019 May.

Abstract

Background: Romiplostim is a thrombopoietin-mimetic peptibody for adult refractory chronic immune thrombocytopenia (ITP). We aimed to describe ITP patients receiving romiplostim, platelet counts and romiplostim usage in UK clinical practice.

Methods: This was a retrospective cohort study of patients in the UKITP Registry who received romiplostim between October 2009 and January 2015, including data up to 6 months before romiplostim initiation through follow-up.

Results: Of 1440 patients in the UKITP Registry, 118 adults with primary ITP were eligible. Before romiplostim, 22% had splenectomy, 12% received platelet transfusion, 97% received ≥ 1 different ITP medication and 77% received ≥ 3. Most patients (73%) initiated romiplostim ≥ 1 year after ITP diagnosis (chronic phase). The mean duration of romiplostim treatment was 5.7 (SE 0.9) months, and the median was 1.4 months (IQR: 0.2, 6.5). Mean platelet count before romiplostim was 38 × 109 /L, rising to 103 × 109 /L within 1 month, and remaining 50-150 × 109 /L through up to 3 years of follow-up. After romiplostim, 4% of patients had splenectomy, 6% received platelet transfusion, and 57% received just one ITP medication other than romiplostim.

Conclusion: The study provides valuable insights into the real-world use of romiplostim in primary ITP in routine practice and highlighted the timing of romiplostim initiation at different ITP disease phases.

Keywords: bleeding; idiopathic thrombocytopenic purpura; platelet; primary immune thrombocytopenia; romiplostim; thrombopoietin receptor agonists.

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Figures

Figure 1
Figure 1
Mean (95% CI) platelet count (x 109/L) following romiplostim initiation
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