Long-term safety and effectiveness of romiplostim for chronic idiopathic thrombocytopenic purpura in real-world settings

Int J Hematol. 2024 Dec;120(6):665-674. doi: 10.1007/s12185-024-03847-4. Epub 2024 Sep 29.

Abstract

Idiopathic thrombocytopenic purpura (ITP), an autoimmune hematologic disorder characterized by severe platelet count reduction, can be treated with romiplostim. However, post-marketing safety and effectiveness data for romiplostim in Japan are scarce. This prospective, observational, post-marketing Specified Use-Results Survey evaluated the real-world safety and effectiveness of romiplostim for 2 years. All patients treated with romiplostim during the survey period were eligible. Of the 1622 patients in the safety analysis set, 94.08% (1526/1622) had chronic ITP. The mean single dose of romiplostim was stable after 12 weeks and remained < 6 μg/kg in approximately 70% of patients until 104 weeks. Within 2 years, 14.92% of patients discontinued romiplostim because of adverse events, while 6.47% discontinued because of suspected adverse drug reactions. In contrast, 14.00% of patients discontinued romiplostim because of symptom improvement. Before romiplostim initiation, platelet count was < 2.0 × 104/µL in 60.54% of patients, and the mean platelet count was 2.84 ± 5.76 × 104/µL. Platelet count was 9.19 ± 13.01 × 104/µL after 4 weeks, and remained between 10.34 ± 10.72 and 12.38 ± 12.63 × 104/µL from 8 to 104 weeks of treatment. No specific concerns were revealed regarding the safety and effectiveness of romiplostim in chronic ITP; the findings demonstrated a favorable risk-benefit balance for romiplostim in this population. Trial registration: UMIN000047864 ( www.umin.ac.jp/ctr ).

Keywords: Chronic idiopathic thrombocytopenic purpura; Japan; Romiplostim; Specified Use-Results Survey; Thrombopoietin.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Platelet Count
  • Product Surveillance, Postmarketing
  • Prospective Studies
  • Purpura, Thrombocytopenic, Idiopathic* / drug therapy
  • Receptors, Fc* / administration & dosage
  • Receptors, Fc* / therapeutic use
  • Recombinant Fusion Proteins* / administration & dosage
  • Recombinant Fusion Proteins* / adverse effects
  • Recombinant Fusion Proteins* / therapeutic use
  • Thrombopoietin* / administration & dosage
  • Thrombopoietin* / adverse effects
  • Thrombopoietin* / therapeutic use
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • romiplostim
  • Recombinant Fusion Proteins
  • Receptors, Fc
  • Thrombopoietin