The Effect of Eltrombopag (Promecta) on Thrombocytopenia in Egyptian Patients with Chronic Hepatitis C

Abstract

Background and aim: Chronic hepatitis C is the leading cause of chronic liver disease and cirrhosis in Egypt. Thrombocytopenia is one of its complications which may postpone or interfere with diagnostic and therapeutic procedures. One of the treatment options of thrombocytopenia is Eltrombopag, Eltrombopag is an orally bioavailability, low molecular weight non-peptide growth factor that is a selective c-Mpl agonist. We aimed to evaluate the ability of Eltrombopag to increase platelet counts in patients with HCV-related thrombocytopenia and to compare it with the use of haematinics.

Study population: The study was conducted on 54 patients with HCV related chronic liver disease and thrombocytopenia (platelet count ˂75.000 /µL). All patients were subjected to complete history taking, clinical evaluation, laboratory investigations and abdominal ultrasonography. Patients were divided into three groups, group (I) twenty four patients received Eltrombopag, group (II) received vitamin B₁₂ and folic acid and group (III) who did not receive any haematenics and considered as a control group.

Results: There was a significant rise in the platelet count in the Eltrombopag group after one and two weeks of treatment when compared to the other groups and more than half of the patients reached the target platelet count (>100,000/μL) after two weeks of treatment with Eltrombopag. There was also a significant negative correlation between AST level and the dose of the drug and a significant positive correlation between the splenic size and the total grams of Eltrombopag needed to reach the target platelet count (p< 0.01). So they may be used as predictors for the response to treatment. Other blood elements did not exhibit any changes during Eltrombopag treatment.

Conclusion: Eltrombopag causes significant selective elevation of platelet count in patients with HCV related thrombocytopenia; this can facilitate diagnostic and therapeutic interventions in such patients.