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Traditional therapies for immune thrombocytopenic purpura (ITP) — corticosteroids, immunoglobulins, immunosuppressives, and splenectomy —primarily act by inhibiting platelet destruction and can have serious adverse effects. Last year, the FDA approved the first two thrombopoietin receptor agonists — injectable romiplostim (Nplate; JW Feb 26 2008) and oral eltrombopag (Promacta; JW Dec 27 2007). Both stimulate platelet production.
In an international manufacturer-funded study, 110 patients who had ITP of at least 6 months’ duration, platelet counts <30,000/μL, and at least one previous treatment for ITP were randomized to daily eltrombopag (50 mg) or placebo for as long as 6 weeks. Patients were allowed to continue other maintenance ITP thera…