Risk of thrombosis with anti-phospholipid syndrome in systemic lupus erythematosus treated with thrombopoietin-receptor agonists

Rheumatology
Zelie GuittonMatthieu Mahevas

Abstract

The use of thrombopoietin-receptor agonists (TPO-RAs) has increased as a second-line therapy in ITP, but the efficacy and safety of such drugs has not been evaluated in SLE-associated ITP. This was a multicentre retrospective cohort study from 2009 to 2016. Participating centres (n = 11) were secondary- or tertiary-care hospitals belonging to the French national network for adult ITP. We included 18 patients with SLE-ITP treated with TPO-RAs; 10 (55%) had aPL, 5 (27%) showing definite APS. Except for one patient, all (94%) achieved response with TPO-RAs overall. After a median follow-up of 14.7 months with TPO-RAs, four arterial thrombosis events (including one catastrophic APS) occurred in four patients. Two venous thrombosis events occurred in a patient without APS or aPLs. Our results suggest that aPLs should be systematically screened before TPO-RA initiation in patients with SLE. With aPL positivity, alternative therapy should be discussed (if possible), especially in patients with definite APS or suboptimal adherence to anti-coagulation therapy.

References

Mar 8, 2002·The New England Journal of Medicine·Jerrold S LevineJoyce Rauch
Jun 15, 2010·Seminars in Arthritis and Rheumatism·Pagalavan Letchumanan, Julian Thumboo
Sep 9, 2010·Rheumatology·Alastair L HepburnJustin C Mason
Aug 26, 2011·The New England Journal of Medicine·Paul Imbach, Mark Crowther
Dec 22, 2011·Platelets·Sif GudbrandsdottirHans Hasselbalch
May 21, 2013·Expert Opinion on Biological Therapy·Simon HallamAdrian C Newland
May 31, 2015·Reumatología clinica·Maria José Moreno MartínezManuel J Moreno Ramos
Nov 9, 2015·American Journal of Hematology·Francesco Rodeghiero
Oct 26, 2016·Journal of Autoimmunity·Alba Velo-GarcíaDavid A Isenberg
Mar 21, 2017·Thrombosis Research·Maeve P CrowleyBeverley J Hunt
Jun 3, 2017·British Journal of Haematology·Tomás J González-LópezJosé R González-Porras

❮ Previous
Next ❯

Citations

Mar 29, 2019·Current Opinion in Rheumatology·Ruba Kado, W Joseph McCune
Jun 6, 2020·Expert Opinion on Investigational Drugs·Rossella TalottaMagdalena Janina Laska
Jun 6, 2019·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Vineeta ShobhaRashmi Roongta
Feb 13, 2019·Current Opinion in Rheumatology·Andrew P VreedeJason S Knight
Jul 24, 2020·Current Rheumatology Reports·Eleni Xourgia, Maria G Tektonidou
Nov 16, 2019·Blood Advances·Marie A HollenhorstDavid J Kuter
Sep 9, 2020·Blood·Hannah Cohen, David A Isenberg
Jul 28, 2020·La Revue de médecine interne·M EbboB Godeau
Nov 4, 2020·La Revue de médecine interne·M MichelL Terriou
Dec 29, 2020·American Journal of Therapeutics·Taif KhattakShahzad Anjum
Jul 28, 2021·Expert Opinion on Biological Therapy·Frederick ChenAdrian Newland

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Polyendocrine Syndromes

This feed focuses on a rare genetic condition called Autoimmune Polyendocrine Syndromes, which are characterized by autoantibodies against multiple endocrine organs. This can lead to Type I Diabetes.

Autoimmune Polyendocrinopathies

Autoimmune polyendocrinopathies, also called polyglandular autoimmune syndromes (PGASs), or polyendocrine autoimmune syndromes(PASs), are a heterogeneous group of rare diseases characterized by autoimmune activity against more than one endocrine organ, although non-endocrine organs can be affected. Discover the latest research on autoimmune polyendocrinopathies here.

Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.