Two cases of thrombosis in patients with antiphospholipid antibodies during treatment of immune thrombocytopenia with romiplostim, a thrombopoietin receptor agonist

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• 作者：Brian LaMoreaux ; MD^a ; ^{brian.lamoreaux@osumc.edu" class="auth_mail" title="E-mail the corresponding author} ; ^{brian.lamoreaux@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Fatima Barbar-Smiley ; MD^b ; Stacy Ardoin ; MD^a ; ^b ; Hareth Madhoun ; DO^a
• 关键词：Antiphospholipid syndrome ; Catastrophic antiphospholipid syndrome ; Romiplostim ; Immune thrombocytopenia
• 刊名：Seminars in Arthritis and Rheumatism
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：45
• 期：4
• 页码：e10-e12
• 全文大小：181 K

文摘

Romiplostim is a thrombopeitin-receptor agonist approved for raising platelet counts in patients with immune thrombocytopenia (ITP). Several hematologic adverse effects have been reported including acute myeloid leukemia, myelofibrosis, and thrombosis.

Methods

We report two cases, one pediatric and one adult patient, who had antiphospholipid antibodies and received romiplostim for ITP. Additionally, we conducted medline, Food and Drug Administration (FDA) Adverse Events reports website, and manufacturer׳s adverse events database.

Results

Both patients developed thrombosis with evidence for catastrophic antiphospholipid syndrome (CAPS) after treatment with romiplostim. No reports or events were found from literature and database searches in regards to thrombosis associated with romiplostim in patients with antiphospholipid syndrome.

Conclusion

These cases illustrate the potential for thrombosis with the administration of romiplostim. The administration of this drug to patients with a history of an autoimmune disease, especially those with positive antiphospholipid antibodies, should be done with caution.