Use of Romiplostim in immune thrombocytopenia: Experience in Cuenca-Ecuador

Abstract

Introduction. Both the international consensus and the American Society of Hematology (ASH) 2019 guideline establish thrombopoietin analogues (TPO) as second-line therapy in primary immune thrombocytopenia (ITP).

Objectives. To describe the usefullness of Romiplostim in patients with immune thrombocytopenia, in a third level hospital in Cuenca-Ecuador.

Materials and methods. Descriptive and retrospective study in patients with immune thrombocytopenia who accessed romiplostim. The following variables were evaluated: age, sex, previous therapies to romiplostim, dose, frequency, complications, change of TPO analogue, and discontinuation.

Results. Twenty-one patients with immune thrombocytopenia used romiplostim, with a median age of 49 years. All patients received first-line corticosteroids. 14.3% required longer intervals than weekly, with doses lower than those recommended (<1ug/kg/weekly). Six patients discontinued thrombopag for romiplostim due to lack of efficacy. 14.3% suffered thrombotic complications: two with portal venous thrombosis, and one with pulmonary thromboembolism. 23.8% were able to discontinue romiplostim without resuming it.

Conclusions. Romiplostim constitutes a convenient second-line therapy in ITP. Despite the small sample size, its early use would minimize toxicities and infectious risks.