Eltrombopag Responses in Arab Patients With Immune Thrombocytopenia

Following reports of varied responses to eltrombopag olamine in patients with immune thrombocytopenia (ITP) from different ethnic groups, researchers led by Mohamed A. Yassin assessed eltrombopag in ethnically Asian and Arab patients. Their article, published in Cureus, found that smaller dosages of eltrombopag were successful in maintaining acceptable platelet levels among these patient populations.

The authors suggested that this finding could help patients derive the most benefit and the lowest viable dose, “reducing toxicity and expense.” They also noted that eltrombopag was generally well-tolerated and effective at achieving desired platelet outcomes in adult patients with chronic ITP.

The researchers retrospectively reviewed electronic health records of non-Arab Asian (n = 17) and Arab (n = 41) patients from a single institution in Qatar. Patients were aged ≥18 years with confirmed diagnoses of chronic ITP and were under active treatment with a platelet count of 30,000/L and bleeding symptoms. Responses to eltrombopag were reviewed after 3 or more months of therapy at dosages ranging from a minimum of 12.5 mg to a maximum dose of the typical 50 mg.

According to the authors, the rate of successful response—defined as a platelet count of 50,000/L—was equivalent between non-Arab and Arab patients at 88.2% and 87.5%, respectively. However, they determined that 26% of Arab patients successfully responded to a lower dose of 12.5 mg or 25 mg, while 41.5% required the full 50 mg dose.

Although the authors noted that their exploratory findings require confirmation in larger-scale studies, they advanced that a “lowest feasible dose” of eltrombopag is capable of providing the greatest benefit to patients, which may help reduce the incidence of adverse effects. They also suggested that “treatment recommendations that are customized to ethnic variations can help individuals and the healthcare system save money.”