Lusutrombopag is Effective and Safe in Patients with Chronic Liver Disease and Severe Thrombocytopenia: A Multicenter Retrospective Study

Abstract

Background: Chronic liver disease (CLD) is often complicated by severe thrombocytopenia (platelet count <50,000/µL). Platelet transfusion has been a gold standard for increasing the platelet count to prevent hemorrhagic events in such patients. Lusutrombopag, a thrombopoietin receptor agonist, can increase the platelet count in such patients when invasive procedures are scheduled. However, we have little information on the effect of lusutrombopag in CLD patients with severe thrombocytopenia in real-world settings.Methods: To investigate the efficacy and safety of lusutrombopag in patients with chronic liver disease and severe thrombocytopenia, we retrospectively investigated 26 CLD patients with a platelet count of <50,000/µL. Lusutrombopag, 3 mg once daily, was administered 8-15 days before scheduled invasive procedures.Results: Among 26 patients who received lusutrombopag, 19 patients (73.1%) patients showed a platelet count of ≥50,000/µL (Group A) and did not require platelet transfusion. The remaining 7 patients (26.9%) did not reached platelet ≥50,000/µL (Group B). The means of platelet increase were 36,000/µL and 13,000/µL in groups A and B, respectively. A low platelet count at baseline was a characteristic of patients in group B. Among 13 patients who repeatedly used lusutrombopag, lusutrombopag significantly increased the platelet count as the initial treatment. No adverse events were noted during or after lusutrombopag treatment. In addition, the degree of platelet increase with lusutrombopag was larger than that in their previous platelet transfusion.Conclusions: Lusutrombopag is effective and safe for CLD patients with a platelet count of <50,000/µL.