Japanese database analysis: effectiveness of early initiation of TPO-RA treatment in tapering corticosteroid dose in ITP

Blood Vessels, Thrombosis & Hemostasis Pub Date : 2025-03-24 DOI:10.1016/j.bvth.2025.100066

Kodai Suzuki , Satoru Ito , Stefano Carini , Mami Shimizu , Shigeki Hatanaka , Yoshitaka Miyakawa

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Abstract

This longitudinal, descriptive study investigated the effect of the timing of thrombopoietin receptor agonist (TPO-RA) initiation on corticosteroid administration and related adverse events (AEs) in patients with immune thrombocytopenia (ITP) in Japan using real-world data from a health claim database. In total, 7696 patients were divided into 3 groups (early TPO-RA initiation, late TPO-RA initiation, and non–TPO-RA administration) by the presence and timing of TPO-RA administration. The early TPO-RA initiation group included patients first administered TPO-RA <60, <120, and <180 days after the index date. The late TPO-RA initiation group included patients first administered TPO-RA ≥60, ≥120, and ≥180 days after the index date. The early TPO-RA initiation group received the highest daily average prednisolone dose, followed by a rapid decrease in dose, similar to that in the non–TPO-RA administration group. In the early TPO-RA initiation group, there was a long-term trend toward daily average prednisolone doses of ≤5 mg, and by approximately 10 to 11 months, the median dose was 0 mg. Diabetes (insulin-dependent) and hypertension tended to occur more frequently in the late TPO-RA (8.4% and 19.9%, respectively) than in the early TPO-RA initiation group (6.9% and 14.4%, respectively). Incidence rates of infections in the late TPO-RA and early TPO-RA initiation groups were similar (7.2% vs 7.6%). The incidence of AEs was similar between male and female patients; a trend toward a higher incidence was observed in those aged ≥60 years. Early initiation of TPO-RA administration can contribute to reducing total prednisolone dosage, treatment duration, and AEs (eg, hypertension and insulin-dependent diabetes).

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日本数据库分析：早期开始TPO-RA治疗在ITP中逐渐减少皮质类固醇剂量的有效性

摘要本纵向描述性研究调查了血小板生成素受体激动剂（TPO-RA）起始时间对日本免疫性血小板减少症（ITP）患者皮质类固醇给药和相关不良事件（ae）的影响，使用健康声明数据库中的真实数据。根据TPO-RA给药的存在和时间，将7696例患者分为TPO-RA早期、TPO-RA晚期和非TPO-RA给药3组。早期TPO-RA起始组包括在指标日期后60、120和180天首次给予TPO-RA治疗的患者。晚期TPO-RA起始组包括在指标日期后≥60、≥120和≥180天首次给予TPO-RA的患者。早期TPO-RA起始组接受的泼尼松龙日平均剂量最高，随后剂量迅速下降，与非TPO-RA给药组相似。在早期TPO-RA起始组中，长期趋势是每日平均泼尼松龙剂量≤5mg，大约10至11个月时，中位剂量为0mg。糖尿病（胰岛素依赖型）和高血压在TPO-RA晚期（分别为8.4%和19.9%）的发生率高于TPO-RA早期（分别为6.9%和14.4%）。TPO-RA晚期和TPO-RA早期发病组的感染发生率相似（7.2% vs 7.6%）。男性和女性患者的ae发生率相似；年龄≥60岁者有较高的发病率趋势。早期给予TPO-RA治疗有助于减少泼尼松龙总剂量、治疗持续时间和不良事件（如高血压和胰岛素依赖型糖尿病）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Blood Vessels, Thrombosis & Hemostasis

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