Eltrombopag Administration in Patients with Active Infection

Introduction to Eltrombopag Therapy

The American Society of Hematology recommends that eltrombopag can be administered to patients with active infection, as infection is not listed as a contraindication in clinical guidelines, with upper respiratory tract infections and urinary tract infections being common adverse events observed in clinical trials without requiring treatment discontinuation 1, 2

Upper respiratory tract infection and urinary tract infection were among the most frequent adverse events (≥5% and greater than placebo) in adult ITP patients treated with eltrombopag, according to the American Journal of Hematology 1, 2
These infections did not lead to systematic treatment discontinuation or represent contraindications to therapy, as noted in the American Journal of Hematology 1, 2

Eltrombopag causes hepatobiliary laboratory abnormalities and hepatotoxicity, with increased ALT occurring in approximately 5-13% of patients, requiring close monitoring of liver function tests, especially in patients with preexisting liver disease, as recommended by the American Association for the Study of Liver Diseases 2, 3, 4
Thrombosis is a treatment-related serious adverse event that requires monitoring for signs of thromboembolism, with exercise caution in patients with preexisting thrombotic risk factors, according to the American Heart Association 1, 2, 5

Weekly platelet monitoring until counts stabilize is recommended by the American Society of Hematology 1, 2
Regular liver function test monitoring throughout therapy is recommended by the American Association for the Study of Liver Diseases 3, 5
Clinical surveillance for thrombotic events, especially in high-risk patients, is recommended by the American Heart Association 1, 2, 5

For ITP patients requiring platelet support during infection, continue or initiate eltrombopag as clinically indicated, according to the American Society of Hematology 1, 2
For hepatitis C-associated thrombocytopenia, eltrombopag is specifically approved to enable antiviral therapy initiation, as noted in the Journal of Hepatology 4
For severe aplastic anemia refractory to immunosuppressive therapy, add eltrombopag to supportive care with response rates of 40-48%, according to the National Institutes of Health 5