Physics

Internal medicine

Retrospective cohort study

Adverse effect

Liver disease

Population

Incidence (geometry)

Gastroenterology

Optics

Surgery

Cirrhosis

Platelet transfusion

Portal vein thrombosis

Thrombosis

Chronic liver disease

Blood transfusion

Cohort

Medicine

Platelet

Environmental health

Digestive Medicine Research

Background: Platelet transfusion is the standard of care for managing thrombocytopenia in patients with advanced liver disease undergoing procedures. Randomized control trials have demonstrated the safety and efficacy of avatrombopag in the management of thrombocytopenia in this population. However, real-world data is limited.Methods: Retrospective cohort study performed in patients 18 and older with thrombocytopenia and liver disease who were prescribed avatrombopag before invasive procedure. Patients were stratified by platelet count into high (>40.0×109/L) and low baseline (<40.0×109/L) cohorts. Demographic, clinical data, changes in platelet count, use of platelet transfusion, rescue therapy, and incidence of portal vein thrombosis were recorded.Results: Of the 29 study patients, 59% were male and the mean age was 62 years. Hepatitis C virus infection was the most common etiology of liver disease (28%) and esophagogastroduodenoscopy was the most common procedure performed (86%). Mean baseline platelet count was 39.3×109/L and 16 patients had platelet counts below 40.0×109/L. Platelet count increased 2.2 folds, from 37.4×109/L to 76.9×109/L in 20 patients who had peri-procedure platelet counts. No patients required rescue therapy or platelet transfusion and there were no adverse effects. There was no new portal vein thrombosis.Conclusions: Results from this real-world study are consistent with the results of the clinical trials for avatrombopag. Avatrombopag is a safe and effective alternative to platelet transfusion to treat thrombocytopenia in patients with chronic liver disease scheduled to undergo a procedure.

Real-life experience with avatrombopag