The effect of three or more administrations of lusutrombopag in patients with cirrhotic thrombocytopenia: A retrospective single-center study.

Aims Thrombocytopenia is a common complication among patients with chronic liver disease (CLD). Lusutrombopag, an oral thrombopoietin receptor agonist, is used to reduce the risk of hemorrhage in patients with thrombocytopenia who are undergoing invasive procedures. Platelet transfusion was the standard treatment for thrombocytopenia; however, multiple platelet transfusions lead to the production of antiplatelet antibody. The effect of administering lusutrombopag three times or more has not been previously reported. In this study, we investigated the effect of lusutrombopag readministration in patients with thrombocytopenia. Methods This study included 14 patients (total, 24 readministrations) who received lusutrombopag two times or more. Changes in platelet counts were evaluated. Treatment response was defined as an increased platelet count of ≥20,000/μL after lusutrombopag administration. Results Lusutrombopag was administered two times in nine patients, three times in three patients, five times in one patient, and six times in one patient. An elevated platelet count of 200,000/μL. One patient had a portal venous mural thrombus; however, he was asymptomatic, and the thrombus resolved after anticoagulant treatment, without recurrence. The comparison between the first, second, and third or more administration, there was no significant difference in platelet increase. Conclusion Repeated administration of lusutrombopag is effective for CLD patients with thrombocytopenia. Moreover, three or more administrations of lusutrombopag showed equal effect compared with one and two administrations of the medication.