Elissa Engel, MD, pediatric resident, University of South Florida, discusses the future of eltrombopag (Promacta) in HIV-related thrombocytopenia.

In a case study presented by Engel, a 13-year old patient with HIV and subsequent thrombocytopenia was treated with eltrombopag after showing poor response to first-line therapies including intravenous immunoglobulin (IVIg). The patient showed clinical response and has been asymptomatic since beginning the medication.

Engel says that she hopes this case brings light to the other potential uses of the medication. HIV thrombocytopenia is not a common disease, and the existing first-line therapies may not work for everybody, explains Engel. Further studies are needed to examine whether eltrombopag could receive an FDA indication for this patient population as well as other causes of thrombocytopenia.

Eltrombopag currently has FDA approval in other indications in adult patients, but is only approved for chronic immune thrombocytopenia in kids.

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Dr. Engel on the Future of Eltrombopag in HIV-Related Thrombocytopenia

Elissa Engel, MD, pediatric resident, University of South Florida, discusses the successful use of eltrombopag (Promacta) in a pediatric patient with HIV-related thrombocytopenia.

A 13-year old patient presented with HIV, which Engel says was most likely acquired prenatally. The patient was treated with first-line therapies including intravenous immunoglobulin (IVIg), but had poor response. After 2 years, the patient required treatment every 3 to 4 weeks, showed response, but then had symptomatic thrombocytopenia.

To treat the thrombocytopenia, Engel and her colleagues decided to treat the patient with eltrombopag based on information gathered from previous literature on the agent. Eltrombopag was dosed at 50 mg per day. The patient showed a clinical response, and has remained asymptomatic since starting the medication. This may imply that eltromopag can be used in patients who do not respond to first-line therapy, Engel says.

Elissa Engel, MD

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Dr. Engel on the Future of Eltrombopag in HIV-Related Thrombocytopenia

Dr. Engel on the Use of Eltrombopag in HIV-Related Thrombocytopenia