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The FDA has approved the first drug in its class, avatrombopag (marketed as Doptelet), to increase platelet count in adults with thrombocytopenia and chronic liver disease who are undergoing a medical or dental procedure.
In two trials including about 500 patients with chronic liver disease and severe thrombocytopenia, those receiving oral avatrombopag in advance showed higher platelet counts and less need for transfusion or rescue therapy on the procedure day compared with placebo recipients. The most common side effects were fever, abdominal pain, nausea, headache, fatigue, and edema.
FDA approves new drug for patients with chronic liver disease who have low blood platelets and are undergoing a medical procedure [press release]. Silver Spring, MD: U.S. Food and Drug Administration; May 21, 2018. (https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608320.htm)
Comment
Avatrombopag will be a welcome option in the management of thrombocytopenia in those undergoing medical and dental procedures and should minimize the use of platelet transfusions in this setting. Clinicians do need to keep in mind that in rare cases, patients with chronic liver disease and those with certain hypercoagulable conditions may have an increased risk for developing blood clots when taking avatrombopag.