Thrombopoietin-receptor agonists in perioperative treatment of patients with chronic liver disease

Table 2 Key safety and tolerability information for thrombopoietin-receptor agonists approved for use[4-7]

Drug	Indication	Boxed warning	AEs	Use in special populations
Romiplostim	Treatment of thrombocytopenia in patients with chronic ITP who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy	None	Thrombotic and thromboembolic events; bone marrow fibrosis; most common AEs: Arthralgia, dizziness, insomnia, myalgia, pain in extremity, abdominal pain, shoulder pain, dyspepsia, and paresthesia, headache	Not to be used in pregnancy and during lactation; safety and effectiveness in pediatric patients has not been established; use in geriatric patients with dose adjustment
Eltrombopag	Treatment of thrombocytopenia in adult and pediatric patients 1 yr and older with chronic ITP who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy; treatment of thrombocytopenia in patients with chronic hepatitis C to allow the initiation and maintenance of interferon-based therapy; treatment of patients with severe aplastic anemia who have had an insufficient response to immunosuppressive therapy	Risk for hepatic decompensation in patients with chronic hepatitis C; risk of hepatotoxicity	Thrombotic and thromboembolic events; hepatoxicity; monitor liver function before and during therapy; increased risk of death and progression of MDS to AML; common AEs in patients with ITP: Nausea, diarrhea, upper respiratory tract infection, vomiting, increased ALT, myalgia and urinary tract infection	Not to be used in pregnancy and during lactation; safety and effectiveness in pediatric patients 1 yr and older with chronic ITP has been established; use in geriatric patients has not been studied in clinical trials; reduced initial dose recommended for patients of East Asian ancestry with ITP
Avatrombopag	Treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure	None	Thrombotic and thromboembolic complications: Monitoring platelet counts essential; common AEs: Pyrexia, abdominal pain, nausea, headache, fatigue, and edema peripheral	Not to be used in pregnancy and during lactation; safety and effectiveness in pediatric patients has not been established; use in geriatric patients has not been studied in clinical trials
Lusutrombopag	Treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure	None	Thrombotic and thromboembolic complications: Monitoring platelet counts essential; most common AE: headache	Not to be used in lactating patients; use in geriatric patients has not been studied in clinical trials; safety and effectiveness in pediatric patients has not been established

AE: Adverse event; AML: Acute myeloid lymphoma; ITP: Immune thrombocytopenia; MDS: Myelodysplastic syndrome.