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Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy.

Publication ,  Journal Article
Patil, AS; Dotters-Katz, SK; Metjian, AD; James, AH; Swamy, GK
Published in: Obstet Gynecol
August 2013

BACKGROUND: Romiplostim, a thrombopoietin mimetic, is a novel therapeutic option for patients with chronic immune thrombocytopenic purpura. We report on the effects of romiplostim use throughout pregnancy. CASE: A 28-year-old primigravid woman with chronic immune thrombocytopenic purpura initiated a planned pregnancy on romiplostim. The second and third trimesters were marked by a cyclic pattern of thrombocytopenia requiring supplemental corticosteroids or intravenous immunoglobulin and resultant thrombocytosis. Increased romiplostim doses and daily corticosteroids stabilized the platelet count before induction of labor at 33 weeks of gestation. The newborn manifested intraventricular hemorrhage at birth, although no developmental delay was present on follow-up at 10 months of age. CONCLUSION: The decreased efficacy of romiplostim monotherapy is attributed to increased target-mediated drug disposition and the physiologic changes of pregnancy. Safety concerns still exist for the developmental effects of romiplostim on the fetus.

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Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

August 2013

Volume

122

Issue

2 Pt 2

Start / End Page

483 / 485

Location

United States

Related Subject Headings

  • Thrombopoietin
  • Recombinant Fusion Proteins
  • Receptors, Thrombopoietin
  • Receptors, Fc
  • Purpura, Thrombocytopenic, Idiopathic
  • Pregnancy Complications, Hematologic
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
 

Citation

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Patil, A. S., Dotters-Katz, S. K., Metjian, A. D., James, A. H., & Swamy, G. K. (2013). Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy. Obstet Gynecol, 122(2 Pt 2), 483–485. https://doi.org/10.1097/AOG.0b013e31828d5b56
Patil, Avinash S., Sarah K. Dotters-Katz, Ara D. Metjian, Andra H. James, and Geeta K. Swamy. “Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy.Obstet Gynecol 122, no. 2 Pt 2 (August 2013): 483–85. https://doi.org/10.1097/AOG.0b013e31828d5b56.
Patil AS, Dotters-Katz SK, Metjian AD, James AH, Swamy GK. Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy. Obstet Gynecol. 2013 Aug;122(2 Pt 2):483–5.
Patil, Avinash S., et al. “Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy.Obstet Gynecol, vol. 122, no. 2 Pt 2, Aug. 2013, pp. 483–85. Pubmed, doi:10.1097/AOG.0b013e31828d5b56.
Patil AS, Dotters-Katz SK, Metjian AD, James AH, Swamy GK. Use of a thrombopoietin mimetic for chronic immune thrombocytopenic purpura in pregnancy. Obstet Gynecol. 2013 Aug;122(2 Pt 2):483–485.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

August 2013

Volume

122

Issue

2 Pt 2

Start / End Page

483 / 485

Location

United States

Related Subject Headings

  • Thrombopoietin
  • Recombinant Fusion Proteins
  • Receptors, Thrombopoietin
  • Receptors, Fc
  • Purpura, Thrombocytopenic, Idiopathic
  • Pregnancy Complications, Hematologic
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female