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Avatrombopag for the treatment of immune thrombocytopenia and thrombocytopenia of chronic liver disease

Authors Cheloff AZ, Al-Samkari H

Received 3 July 2019

Accepted for publication 1 August 2019

Published 5 September 2019 Volume 2019:10 Pages 313—321

DOI https://doi.org/10.2147/JBM.S191790

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Martin H. Bluth


Abraham Z Cheloff, Hanny Al-Samkari

Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Correspondence: Hanny Al-Samkari
Division of Hematology, Massachusetts General Hospital, Suite 118, Room 112, Zero Emerson Place, Boston, MA 02114, USA
Tel +1 617 643 6214
Fax +1 617 643 8840
Email hal-samkari@mgh.harvard.edu

Abstract: Avatrombopag is an orally-administered small molecule thrombopoietin receptor agonist. It was the third thrombopoietin receptor agonist approved for the treatment of immune thrombocytopenia and the first approved to treat periprocedural thrombocytopenia in patients with chronic liver disease (thereby providing an alternative to blood transfusions for these patients). Unlike eltrombopag, avatrombopag does not require a 4 hr food-restricted window around its use and it has not been associated with hepatotoxicity in ITP patients or portal vein thrombosis in patients with chronic liver disease. In ITP patients it can often be dosed less frequently than once daily. It is overall well-tolerated with a side-effect profile similar to placebo in randomized clinical trials. This article will review the clinical development, efficacy, safety, and pharmacology of avatrombopag for use in patients with ITP and thrombocytopenia of chronic liver disease.

Keywords: avatrombopag, thrombocytopenia, purpura, thrombocytopenia, idiopathic, liver diseases, liver cirrhosis, receptors, thrombopoietin, thrombopoietin, hematologic agents, hemorrhage, surgery

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