Efficacy of eltrombopag on refractory primary immune thrombocytopenia and its effect on cellular immune function

doi:10.5246/jcps.2023.09.060

Abstract

Abstract:

To investigate the clinical effects of eltrombopag in treating refractory primary immune thrombocytopenia (ITP) and its impact on cellular immune function, we selected 132 patients with refractory ITP admitted to our hospital between January 2019 and October 2022. They were divided into three groups: the combined treatment group (44 cases), the single treatment group (44 cases), and the complete control group (44 cases). The combined treatment group received etrapopa combined with vindesine, the single treatment group received eltrombopag, and the complete control group only received lifestyle intervention. The treatment course was 12 weeks. We compared the clinical efficacy and adverse reactions of the three groups and collected peripheral blood samples before and after treatment to detect changes in platelet count (PLT), bleeding time (BT), T lymphocyte subsets (CD₄⁺, CD₈⁺), B lymphocyte subsets (CD₁₉⁺, CD₂₀⁺), Th1 cytokines (IFN-γ, IL-2), and Th2 cytokines (IL-5, IL-4). After treatment, the complete response rate in the single treatment group was significantly higher than that in the complete control group, and the complete response rate in the combined treatment group was significantly higher than that in the single treatment group (both P < 0.05). The total effective rate in the combined treatment group was also higher than that in the single treatment group (P < 0.05). Compared with the complete control group, the PLT and BT values in the single treatment group were significantly improved after treatment (P < 0.05), and the combined treatment group had significantly improved PLT and BT values compared to the single treatment group (P < 0.05). The CD₄⁺/CD₈⁺ and CD₁₉⁺/CD₂₀⁺ values in the single treatment group were significantly improved after treatment compared with the complete control group (P < 0.05), and the combined treatment group showed significantly improved CD₄⁺/CD₈⁺ and CD₁₉⁺/CD₂₀⁺ values compared to the single treatment group (P < 0.05). Serum IFN-γ and IL-2 levels in the single and combined treatment groups were significantly lower than those in the complete control group after 12 weeks of treatment, while the levels of serum IL-5 and IL-4 were significantly higher (P < 0.05). The combined treatment group had significantly higher serum IL-5 and IL-4 levels than the single treatment group after 12 weeks of treatment (P < 0.05). The incidence of adverse reactions among the three groups was not significantly different (P > 0.05). In conclusion, for patients with refractory primary ITP, combined therapy of eltrombopag and immunosuppressants is safe and effective, improving cellular immune function.

Key words: Primary immune thrombocytopenia, Eltrombopag, Clinical efficacy, Cellular immune function

Supporting:

Hanchun Yang, Fei Cheng, Juanjuan Huang. Efficacy of eltrombopag on refractory primary immune thrombocytopenia and its effect on cellular immune function[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(9): 736-743.

Figures/Tables 3

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