Switching patients with immune thrombocytopenia ( <scp>ITP)</scp> to avatrombopag from other thrombopoietin receptor agonists: The real‐world experience of the Spanish <scp>ITP</scp> Group ( <scp>GEPTI</scp> )

Summary Avatrombopag is a thrombopoietin receptor agonist (TPO‐RA) suitable for patient‐centred care. Avatrombopag achieved lasting platelet count (PC) increases in small series of immune thrombocytopenia (ITP) patients in whom other TPO‐RAs had failed. We recruited 208 patients with ITP who switched from eltrombopag or romiplostim to avatrombopag due to ineffectiveness (115 [55.3%]), convenience (66 [31.7%]) or treatment‐emergent adverse events (TEAEs) (27 [13.0%]). Patients were followed up for 63.9 (31.1–100.4) weeks (median [interquartile range]). Ninety‐two per cent of switchers due to ineffectiveness who had baseline PC &lt;50 × 10 9 /L responded to avatrombopag (PC ≥50 × 10 9 /L with doubling of baseline values). Response was maintained in 81.2% of patients after 56.4 (24.6–90.2) weeks. Ninety‐two per cent of switchers due to convenience or TEAEs maintained a long‐term response. Fifty‐one per cent of switchers due to TPO‐RA failure who used concomitant medications discontinued these while on avatrombopag. In switchers due to convenience or TEAEs, the maintenance dose decreased from 140 (140–140) to 80 (60–140) mg/week. Fourteen patients (6.7%) discontinued avatrombopag due to TEAEs. The thromboembolism rate was 3.8%. No new safety concerns arose. In this large real‐world cohort, switching from eltrombopag or romiplostim to avatrombopag safely induced durable PC recovery.

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Publication Details

Journal
British Journal of Haematology
Published
2026-05-29
DOI
https://doi.org/10.1111/bjh.70595
Primary Topic
Platelet Disorders and Treatments
Type
article
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article

Switching patients with immune thrombocytopenia ( ITP) to avatrombopag from other thrombopoietin receptor agonists: The real‐world experience of the Spanish ITP Group ( GEPTI )

Denis Zafra, Daniel Martínez‐Carballeira, Teresa Arquero‐Portero, Patricia Alcalde‐Mellado et al.
British Journal of Haematology
Platelet Disorders and Treatments
article

Switching patients with immune thrombocytopenia ( ITP) to avatrombopag from other thrombopoietin receptor agonists: The real‐world experience of the Spanish ITP Group ( GEPTI )

Denis Zafra, Daniel Martínez‐Carballeira, Teresa Arquero‐Portero, Patricia Alcalde‐Mellado, Cristina Fernández‐Canal, Gonzalo Caballero‐Navarro, Begoña Pedrote Amador, Gerardo Aguilar-Monserrate, Cristina Pascual, J. Bastida, Manuel Rodríguez López, Maria-Teresa Álvarez-Roman, Nuria Revilla‐Calvo, Maialen Lasa‐Eguialde, Sara Carbonell, Pablo García-Jaén, Alicia Ortiz-Lopez, Marta Canet‐Maldonado, Carla Alonso-Martínez, Eduardo Morales‐Espino, Sheila Carrasco‐Macedo, María‐del‐Carmen Gómez‐del‐Castillo, María Remezal‐Serrano, Sonia Piernas‐Fontanilla, Sandra García‐Lázaro, Laura Hernández‐Vázquez, Emma Serrasolses‐Alemany, David Valcárcel, Isabel González‐Gascón‐y‐Marín, Mariana Canaro‐Hirnyk, Anna Martín‐Carrizosa, Marta Cervera, Patricia González‐Marugán, Andrés Ramírez‐López, Blanca Sánchez‐González, the Spanish ITP Group (GEPTI), Estefanía Bolaños‐Caderón, Javier Bañón‐Soria, María‐Eva Mingot‐Castellano, Teresa Cobo‐Rodríguez
article en

Abstract

Summary Avatrombopag is a thrombopoietin receptor agonist (TPO‐RA) suitable for patient‐centred care. Avatrombopag achieved lasting platelet count (PC) increases in small series of immune thrombocytopenia (ITP) patients in whom other TPO‐RAs had failed. We recruited 208 patients with ITP who switched from eltrombopag or romiplostim to avatrombopag due to ineffectiveness (115 [55.3%]), convenience (66 [31.7%]) or treatment‐emergent adverse events (TEAEs) (27 [13.0%]). Patients were followed up for 63.9 (31.1–100.4) weeks (median [interquartile range]). Ninety‐two per cent of switchers due to ineffectiveness who had baseline PC &lt;50 × 10 9 /L responded to avatrombopag (PC ≥50 × 10 9 /L with doubling of baseline values). Response was maintained in 81.2% of patients after 56.4 (24.6–90.2) weeks. Ninety‐two per cent of switchers due to convenience or TEAEs maintained a long‐term response. Fifty‐one per cent of switchers due to TPO‐RA failure who used concomitant medications discontinued these while on avatrombopag. In switchers due to convenience or TEAEs, the maintenance dose decreased from 140 (140–140) to 80 (60–140) mg/week. Fourteen patients (6.7%) discontinued avatrombopag due to TEAEs. The thromboembolism rate was 3.8%. No new safety concerns arose. In this large real‐world cohort, switching from eltrombopag or romiplostim to avatrombopag safely induced durable PC recovery.

British Journal of Haematology
Hospital Universitario Insular de Gran Canaria (ES), Hospital Universitario La Paz (ES), University Hospital Complex Of Vigo (ES), Hospital General Universitario Gregorio Marañón (ES), Hospital Clínico San Carlos (ES), Hospital de Basurto (ES), Hospital Universitario 12 De Octubre (ES), Hospital Universitario Miguel Servet (ES), Hospital de Sabadell (ES), Hospital Universitario del Sureste (ES), Vall d'Hebron Hospital Universitari (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Hospital Del Mar (ES), Instituto de Biomedicina de Sevilla (ES), Hospital Universitario Central de Asturias (ES), Instituto de Investigación Biomédica de Salamanca (ES), Complexo Hospitalario Universitario A Coruña (ES), Hospital Universitario De Cabueñes (ES), Hospital Universitari Joan XXIII de Tarragona (ES), Hospital Universitario Son Espases (ES), Hospital Municipal de Badalona (ES), Hospital Universitario Virgen del Rocío (ES), Hospital Universitari de Girona Doctor Josep Trueta (ES), Hospital Clínico Universitario de Valladolid (ES), Hospital Universitario Severo Ochoa (ES), Complejo Hospitalario Universitario de Toledo (ES), Hospital Universitario Infanta Leonor (ES), Hospital Universitario de Toledo (ES), Universidad de Sevilla (ES)
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Platelet Disorders and Treatments
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