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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Patil, AS; Dotters-Katz, SK; Metjian, AD; James, AH; Swamy, GK

Published Date

  • August 2013

Published In

Volume / Issue

  • 122 / 2 Pt 2

Start / End Page

  • 483 - 485

PubMed ID

  • 23884268

Pubmed Central ID

  • PMC4011074

Electronic International Standard Serial Number (EISSN)

  • 1873-233X

Digital Object Identifier (DOI)

  • 10.1097/AOG.0b013e31828d5b56


  • eng

Conference Location

  • United States