Avatrombopag for the treatment of immune thrombocytopenia and thrombocytopenia of chronic liver disease

Abraham Z Cheloff, Hanny Al-Samkari, Abraham Z Cheloff, Hanny Al-Samkari

Abstract

Avatrombopag is an orally-administered small molecule thrombopoietin receptor agonist. It was the third thrombopoietin receptor agonist approved for the treatment of immune thrombocytopenia and the first approved to treat periprocedural thrombocytopenia in patients with chronic liver disease (thereby providing an alternative to blood transfusions for these patients). Unlike eltrombopag, avatrombopag does not require a 4 hr food-restricted window around its use and it has not been associated with hepatotoxicity in ITP patients or portal vein thrombosis in patients with chronic liver disease. In ITP patients it can often be dosed less frequently than once daily. It is overall well-tolerated with a side-effect profile similar to placebo in randomized clinical trials. This article will review the clinical development, efficacy, safety, and pharmacology of avatrombopag for use in patients with ITP and thrombocytopenia of chronic liver disease.

Keywords: avatrombopag; hematologic agents; hemorrhage; idiopathic; liver cirrhosis; liver diseases; purpura; receptors; surgery; thrombocytopenia; thrombopoietin.

Conflict of interest statement

Dr Hanny Al-Samkari report personal fees and research funding from Agios and Dova, and personal fees from Moderna, outside the submitted work. The authors report no other conflicts of interest in this work.

© 2019 Cheloff and Al-Samkari.

Figures

Figure 1
Figure 1
Molecular structure of avatrombopag.

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