1. Introduction
bleeding, hematological abnormalities, TPO-RAs, thrombocytopenia, cirrhosis, hepatocellular carcinoma, transfusion-associated, CLD
CHRONIC LIVER DISEASE, BLEEDING, THROMBOCYTOPENIA, ADVERSE EVENTS, THROMBOCYTOPENIA, CIRRHOSIS, HEPATOCELLULAR CARCINOMA, PORTAL VEIN THROMBOSIS, CLD, CHRONIC LIVER DISEASE
The phase 4 observational cohort study assessed the effectiveness and safety of the thrombopoietin receptor agonist avatrombopag in patients with chronic liver disease (CLD) and thrombocytopenia undergoing a procedure. Patients with CLD may have thrombocytopenia, increasing the risk of periprocedural bleeding. Prophylactic platelet transfusions used to reduce this risk have limitations including lack of efficacy and transfusion-associated reactions. Prophylactic thrombopoietin receptor agonists have been shown to increase platelet counts and decrease platelet transfusions. Effectiveness was assessed by change from baseline in platelet count and proportion of patients needing a platelet transfusion. Safety was assessed by monitoring adverse events (AEs). Of 50 patients enrolled, 48 were unique patients and 2 patients were enrolled twice for separate procedures. The mean (standard deviation) change in platelet count from baseline to procedure day was 41.1 × 10Chronic liver disease (CLD) is associated with hematological abnormalities,Thrombocytopenia in patients with CLD is nearly always linked to cirrhosis,Invasive surgical and therapeutic procedures, such as liver biopsies, variceal band ligation, or percutaneous procedures for hepatocellular carcinoma are common in patients with CLD.Prophylactic platelet transfusion is commonly used to improve thrombocytopenia in patients with CLD,Given the drawbacks of traditional treatments, focus has shifted to the use of thrombopoietin receptor agonists (TPO-RAs), which interact with the thrombopoietin receptor on megakaryocytes resulting in an increase in platelet production.Recent meta-analyses indicated that the use of TPO-RAs prior to procedures results in increased platelet counts and decreased incidence of platelet transfusions, compared with placebo, whilst having no significant effect on the rate of portal vein thrombosis.This phase 4 observational cohort study was designed to assess the real-world effectiveness, safety, and treatment patterns of avatrombopag in patients with thrombocytopenia associated with CLD undergoing a procedure.