Sistema de Salut de Catalunya
Institut Català de la Salut
[Lozano ML] Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain. [Mingot-Castellano ME] Hospital Carlos Haya, Málaga, Hospital Universitario Virgen del Rocio, Sevilla, Spain. [Perera MM] Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain. [Jarque I] Hospital Universitario y Politécnico La Fe, Valencia, Spain. [Campos-Alvarez RM] Hospital de Especialidades de Jerez de la Frontera, Cádiz, Spain. [González-López TJ] Hospital Universitario de Burgos, Burgos, Spain. [Valcarcel D] Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2021-07-09T06:47:17Z
2021-07-09T06:47:17Z
2021-02
Gent gran; Pautes; TPO-RA
Ancianos; Pautas; TPO-RA
Elderly; Guidelines; TPO-RA
Background Ten years after their availability, thrombopoietin receptor agonists (TPO-RA) have heralded a paradigm shift in the treatment of immune thrombocytopenia (ITP). This study was aimed to analyze the implementation of current recommendations in the standard practice of adult ITP patients, and how age may influence those changes. Methods We included 121 adult patients (> 65 years, n = 54; younger individuals, n = 67) who initiated treatment with TPO-RA between January 2012 and December 2014. Results Patients older than 65 years treated with TPO-RA presented at diagnosis with significantly higher platelet counts, less bleeding, and a more prothrombotic profile than younger ones. The high efficacy rates of TPO-RA, preferentially used during the last decade in non-chronic phases, precluded from further therapies in the majority of ITP patients. Their administration was associated with a sharp decline in the last decade in the use of splenectomy and intravenous immunoglobulin, especially in younger ITP individuals. Conclusion These results confirm (1) that there is a preferential use of TPO-RAs in elderly ITP patients with fewer bleeding complications but more unfavorable prothrombotic conditions than in younger individuals, and (2) that early use of these agents has been established as an effective therapeutic alternative to other second line therapies.
This work was supported by Amgen S.A. Spain. Amgen did not have any role in study design, collection, analysis, and interpretation of data, writing the report, or in the decision to submit the report for publication.
Article
Published version
English
Citocines - Receptors; Persones grans; Trombocitopènia - Tractament; CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Membrane Proteins::Receptors, Cell Surface::Receptors, Immunologic::Receptors, Cytokine::Receptors, Thrombopoietin; Other subheadings::Other subheadings::Other subheadings::/agonists; DISEASES::Immune System Diseases::Autoimmune Diseases::Immune System Diseases::Purpura, Thrombocytopenic, Idiopathic; NAMED GROUPS::Persons::Age Groups::Adult::Aged; COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas de membranas::receptores de superficie celular::receptores inmunológicos::receptores de citocinas::receptores de trombopoyetina; Otros calificadores::Otros calificadores::Otros calificadores::/agonistas; ENFERMEDADES::enfermedades del sistema inmune::enfermedades del sistema inmune::púrpura trombocitopénica::púrpura trombocitopénica idiopática; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adulto::anciano
Elsevier
Blood Cells, Molecules, and Diseases;86
https://www.sciencedirect.com/science/article/pii/S1079979620304563?via%3Dihub
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
Articles científics - HVH [3440]
