Abstract:
INTRODUCTION:In patients with chronic idiopathic thrombocytopenic purpura (cITP), the platelet count tends to be quite variable and, in the majority of cases, specific therapy is not warranted on a regular basis. However, patients with low platelet count (<30 nL) or with bleeding complications would require therapy, such as prednisolone, intravenous immunoglobulin infusions, splenectomy and/or immunosuppression. Romiplostim, a thrombopoietin agonist, has also proven to be useful in improving platelet counts. cITP can be associated with bleeding complications perioperatively. As such, a higher platelet count is warranted (approximately 80 nL), particularly for invasive surgeries, such as orthopaedic surgery, cardio-thoracic surgery, head and neck surgery and abdominal surgery, where risk of bleeding is quite high already. AIM:The aim of this study is to evaluate the safety and efficacy of short-term use of romiplostim, perioperatively. METHODS:Patients with chronic ITP requiring major surgical interventions were enrolled in the study. Patients with malignancies or myelodysplastic syndromes, major bleeding disorders, under 18 years of age or pregnancy were excluded. CONCLUSION:This study has shown that the use of romiplostim is safe and effective in improving platelet counts preoperatively and that this could achieve excellent haemostasis, with no associated bleeding complications or rebound thrombocytopenia. A larger study involving multiple centres is required to verify these findings.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Ramakrishna R,Rehman A,Ramakrishna S,Alexander W,Yeo WWdoi
10.1111/imj.12794subject
Has Abstractpub_date
2015-07-01 00:00:00pages
718-24issue
7eissn
1444-0903issn
1445-5994journal_volume
45pub_type
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