Safety and efficacy of self-administered romiplostim in patients with immune thrombocytopenia: Results of an integrated database of five clinical trials

. 2020 Jun ; 95 (6) : 643-651. [epub] 20200321

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie

Perzistentní odkaz   https://www.medvik.cz/link/pmid32129511

Romiplostim self-administration by patients or caregivers may offer time/cost savings to healthcare professionals (HCPs) and convenience for patients who avoid weekly clinic visits. We performed an integrated analysis of five clinical trials to evaluate the efficacy and safety of romiplostim self-administration. Data were analyzed from adults with immune thrombocytopenia (ITP) who received weekly romiplostim via self-administration or from an HCP. Patients who achieved a stable romiplostim dose for ≥3 weeks (HCP group ≥5 weeks to provide an appropriate index date to enable comparisons with the self-administration group) with platelet counts ≥50 × 109 /L were eligible. In the self-administration (n = 621) vs HCP (n = 133) groups, respectively, median age was 53 vs 58 years, median time since primary ITP diagnosis was 3.7 vs 2.5 years, and median baseline platelet count at ITP diagnosis was 19.0 vs 20.0 × 109 /L. In the self-administration and HCP-dosed groups, median romiplostim treatment duration was 89 vs 52 weeks and median total number of doses was 81 vs 50, respectively. In the self-administration and HCP groups, respectively: 95.0% and 100.0% of patients achieved ≥1 platelet response (defined as weekly platelet count ≥50 × 109 /L without rescue medication in previous 4 weeks); the median percentage of weeks with a response was 94.5% and 95.9%; and rescue medication was used in 36.7% and 39.8% of patients. Self-administration did not adversely affect safety; duration-adjusted rates for all treatment-emergent adverse events (TEAEs) and bleeding TEAEs were numerically lower with self-administration. Romiplostim self-administration appears effective and well tolerated in eligible patients with ITP.

Zobrazit více v PubMed

Cooper N, Bussel J. The pathogenesis of immune thrombocytopaenic purpura. Br J Haematol. 2006;133(4):364‐374. PubMed

Neunert C, Noroozi N, Norman G, et al. Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review. J Thromb Haemost. 2015;13(3):457‐464. PubMed PMC

Tarantino MD, Mathias SD, Snyder CF, Isitt JJ, Gernsheimer T, Young J. Impact of ITP on physician visits and workplace productivity. Curr Med Res Opin. 2010;26(2):319‐328. PubMed

Hill QA, Newland AC. Fatigue in immune thrombocytopenia. Br J Haematol. 2015;170(2):141‐149. PubMed

Molineux G, Newland A. Development of romiplostim for the treatment of patients with chronic immune thrombocytopenia: from bench to bedside. Br J Haematol. 2010;150(1):9‐20. PubMed

Highlights of prescribing information . NPLATE® (romiplostim) for injection, for subcutaneous use. Initial US Approval: 2008. 2018. https://www.pi.amgen.com/~/media/amgen/repositorysites/pi‐amgen‐com/nplate/nplate_pi_hcp_english.pdf. Revised October, 2019. Accessed March 16, 2020.

Nplate summary of product characteristics (SmPC) ‐ (eMC). 2013. https://www.ema.europa.eu/en/documents/product‐information/nplate‐epar‐product‐information_en.pdf. Accessed March 16, 2020.

PR Newswire Association. Amgen submits supplemental biologics license application for Nplate® (romiplostim). 2018. https://www.prnewswire.com/news‐releases/amgen‐submits‐supplemental‐biologics‐license‐application‐for‐nplate‐romiplostim‐300769133.html. Accessed March 16, 2020.

Selleslag D, Bird R, Altomare I, et al. Impact of self‐administration of romiplostim by patients with chronic immune thrombocytopenia compared with administration by a healthcare provider. Eur J Haematol. 2014;94(2):169‐176. PubMed

Amgen. Selecting and training adult patients for home administration of NPLATE® (Romiplostim). 2018. https://www.medicines.org.uk/emc/rmm/272/Document. Accessed March 16, 2020.

Bussel JB, Kuter DJ, Pullarkat V, Lyons RM, Guo M, Nichol JL. Safety and efficacy of long‐term treatment with romiplostim in thrombocytopenic patients with chronic ITP. Blood. 2009;113(10):2161‐2171. PubMed

Kuter DJ, Bussel JB, Newland A, et al. Long‐term treatment with romiplostim in patients with chronic immune thrombocytopenia: safety and efficacy. Br J Haematol. 2013;161(3):411‐423. PubMed

Kuter DJ, Rummel M, Boccia R, et al. Romiplostim or standard of care in patients with immune thrombocytopenia. N Engl J Med. 2010;363(20):1889‐1899. PubMed

Janssens A, Tarantino M, Bird RJ, et al. Romiplostim treatment in adults with immune thrombocytopenia of varying duration and severity. Acta Haematol. 2015;134(4):215‐228. PubMed

Lyons RM, Boccia RV, Macik G, et al. Home administration of romiplostim by patients with chronic immune thrombocytopenia (ITP). Blood. 2009;114(22):3510.

Terrell DR, George JN, Bussel JB, et al. Self‐administration of romiplostim in patients with chronic immune thrombocytopenia. Community Oncol. 2013;10:285‐292.

Janssens A, Rodeghiero F, Anderson D, et al. Changes in bone marrow morphology in adults receiving romiplostim for the treatment of thrombocytopenia associated with primary immune thrombocytopenia. Ann Hematol. 2016;95(7):1077‐1087. PubMed PMC

Newland A, Godeau B, Priego V, et al. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol. 2016;172(2):262‐273. PubMed

Schipperus M, Kaiafa G, Taylor L, et al. Assessment of self‐administration of romiplostim in patients with immune thrombocytopenic purpura after receipt of home administration training materials: a cross‐sectional study. Drug Saf. 2019;42(1):77‐83. PubMed PMC

Steurer M, Quittet P, Papadaki HA, et al. A large observational study of patients with primary immune thrombocytopenia receiving romiplostim in European clinical practice. Eur J Haematol. 2017;98(2):112‐120. PubMed

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...