Two cases of thrombosis in patients with antiphospholipid antibodies during treatment of immune thrombocytopenia with romiplostim, a thrombopoietin receptor agonist.
Two cases of thrombosis in patients with antiphospholipid antibodies during treatment of immune thrombocytopenia with romiplostim, a thrombopoietin receptor agonist.
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DOI：
10.1016/j.semarthrit.2015.07.008
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发表时间：
2016-02-01
影响因子：
5
通讯作者：
Madhoun, Hareth
中科院分区：
文献类型：
--
作者：
LaMoreaux, Brian;Barbar-Smiley, Fatima;Madhoun, Hareth
简介：Romiplostim 是一种血小板生成素受体激动剂，被批准用于提高免疫性血小板减少症 (ITP) 患者的血小板计数。已报道了几种血液学不良反应，包括急性髓性白血病、骨髓纤维化和血栓形成。方法：我们报告了两例患者，一名儿童和一名成人患者，他们有抗磷脂抗体并接受罗米司亭治疗 ITP。此外，我们还对 medline、美国食品和药物管理局 (FDA) 不良事件报告网站以及制造商的不良事件数据库进行了调查。结果：两名患者在使用 romiplostim 治疗后均出现血栓形成，并有灾难性抗磷脂综合征 (CAPS) 的证据。从文献和数据库检索中未发现有关抗磷脂综合征患者与 romiplostim 相关的血栓形成的报告或事件。 结论：这些病例说明了使用 romiplostim 可能导致血栓形成。有自身免疫性疾病病史的患者，尤其是抗磷脂抗体阳性的患者，应谨慎使用该药。
INTRODUCTION: Romiplostim is a thrombopeitin-receptor agonist approved for raising platelet counts in patients with immune thrombocytopenia (ITP). Several hematologic adverse effects have been reported including acute myeloid leukemia, myelofibrosis, and thrombosis.METHODS: We report two cases, one pediatric and one adult patient, who had antiphospholipid antibodies and received romiplostim for ITP. Additionally, we conducted medline, Food and Drug Administration (FDA) Adverse Events reports website, and manufacturer's adverse events database.RESULTS: Both patients developed thrombosis with evidence for catastrophic antiphospholipid syndrome (CAPS) after treatment with romiplostim. No reports or events were found from literature and database searches in regards to thrombosis associated with romiplostim in patients with antiphospholipid syndrome.CONCLUSION: These cases illustrate the potential for thrombosis with the administration of romiplostim. The administration of this drug to patients with a history of an autoimmune disease, especially those with positive antiphospholipid antibodies, should be done with caution.