Abstract
Chronic liver disease (CLD) alters normal hemostatic and thrombotic systems via multiple mechanisms including reduced platelet function and number, leading to challenging peri-operative planning. Hepatic thrombopoietin (TPO) synthesis is reduced in CLD, leading to several recent randomized, placebo-controlled trials examining the utility of TPO-mimetics to increase platelet counts prior to surgery. While these trials do suggest that TPO-mimetics are efficacious at increasing platelet counts in patients with CLD and have led to several recent drug approvals in this space by the U.S. Food & Drug Administration, it remains unclear whether these results translate to the relevant clinical endpoint of reduced perioperative bleeding rate and severity. In this article, we review several recently-published, phase 3 trials on the TPO-mimetics eltrombopag, avatrombopag and lusutrombopag, and discuss the clinical significance of their results.
Original language | English (US) |
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Pages (from-to) | 796-798 |
Number of pages | 3 |
Journal | Platelets |
Volume | 30 |
Issue number | 6 |
DOIs | |
State | Published - Aug 18 2019 |
Keywords
- Bleeding
- Platelets
- thrombopoietin
ASJC Scopus subject areas
- Hematology