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Predictors for eltrombopag response in patients with hepatitis C virus-associated thrombocytopenia

Authors Elbedewy TA, Elsebaey MA, Elshweikh SA, Elashry H, Abd-Elsalam S

Received 1 September 2018

Accepted for publication 3 December 2018

Published 11 February 2019 Volume 2019:15 Pages 269—274


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh

Tamer A Elbedewy,1 Mohamed A Elsebaey,1 Samah A Elshweikh,1 Heba Elashry,2 Sherief Abd-Elsalam2

1Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Background and aims: Thrombocytopenia is a common hematological abnormality observed in patients infected with hepatitis C virus (HCV). The use of eltrombopag has been approved for HCV-associated thrombocytopenia. This is the first study aiming to determine the predictive factors of response to eltrombopag therapy in patients with HCV-associated thrombocytopenia.
Patients and methods: This prospective study was carried out on 130 patients with chronic HCV-associated thrombocytopenia (<50,000×109/L) that precludes the initiation of HCV therapy. Eltrombopag was initiated at a dose of 25 mg once daily; the dose was adjusted with 25 mg increments every 2 weeks to achieve the target platelet count. The primary end point was to achieve stable target platelet count (50,000–100,000×109/L) required to initiate antiviral therapy.
Results: Treatment response was achieved in 111 (85.38%) patients. This prospective study showed that megakaryocyte hypoplasia or aplasia and splenectomy were independent risk factors for eltrombopag nonresponse in chronic HCV-associated thrombocytopenic patients.
Conclusion: Eltrombopag is safe and effective for patients with HCV-associated thrombocytopenia. Bone marrow examination should be considered before initiating treatment with eltrombopag in chronic HCV-associated thrombocytopenic patients, especially in patients with splenectomy.

Keywords: HCV, therapy, thrombocytopenia, predictors, splenectomy, direct-acting antivirals, DAAs

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