Second-generation thrombopoietin receptor agonists: New players in the management of cirrhotic patients undergoing therapeutic endoscopy?

Published on Jun 1, 2021in Digestive and Liver Disease3.57
· DOI :10.1016/J.DLD.2021.05.007
Franco Radaelli33
Estimated H-index: 33
,
Cesare Hassan92
Estimated H-index: 92
+ 2 AuthorsLorenzo Fuccio10
Estimated H-index: 10
(UNIBO: University of Bologna)
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Prophylaxis 1 ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic retrograde cholangiopancreatography (ERCP) in all patients without contraindications to nonsteroidal anti-inflammatory drug administration. Strong recommendation, moderate quality evidence. 2 ESGE recommends prophylactic pancreatic stenting in selected patients at high risk for post-ERCP pancreatitis (inadvertent guidewire insertion/opacification of the pancreatic duc...
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#1M Peck-Radosavljevic (MIT: Massachusetts Institute of Technology)H-Index: 6
#1Markus Peck-Radosavljevic (MIT: Massachusetts Institute of Technology)H-Index: 1
Last. Nezam H. Afdhal (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 92
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: Thrombocytopenia may be associated with increased bleeding risk impacting timing and outcome of invasive procedures in patients with chronic liver disease (CLD). Lusutrombopag, a small-molecule, thrombopoietin (TPO) receptor agonist, was evaluated as a treatment to raise platelet counts (PCs) in patients with thrombocytopenia and CLD undergoing invasive procedures. L-PLUS 2 was a global, phase 3, randomized, double-blind, placebo-controlled study. Adults with CLD and baseline PCs < 50 × 109 /L...
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#1Hisashi Hidaka (Kitasato University)H-Index: 19
#2Masayuki KurosakiH-Index: 51
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Background & Aims Platelet transfusion is used to prevent hemorrhagic events in patients with thrombocytopenia undergoing invasive procedures, but there are many disadvantages. We evaluated the efficacy and safety of lusutrombopag in patients with chronic liver disease and thrombocytopenia undergoing invasive procedures. Methods We performed a double-blind, parallel-group, phase 3 study of 96 patients with chronic liver disease and thrombocytopenia (platelet counts below 50,000/μL) undergoing in...
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#1Norah A. Terrault (UCSF: University of California, San Francisco)H-Index: 87
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Abstract Background & Aims Patients with thrombocytopenia and chronic liver disease (CLD) may require platelet transfusions before scheduled procedures to decrease risk of bleeding. We performed 2 randomized, placebo-controlled, phase 3 trials in patients with thrombocytopenia and CLD undergoing scheduled procedures to evaluate the safety and efficacy of avatrombopag in increasing platelet counts in this patient population Methods In the ADAPT-1 and ADAPT-2 studies, adults with thrombocytopenia ...
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#1Silvia PaggiH-Index: 27
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Abstract Background The provision of high-quality colonoscopy can be assessed by evaluating technical aspects of the procedure and, at individual center level, by comparing structural indicators and institutional policies for managing peri-procedural issues with guideline recommendations. Aim To assess the colonoscopy quality (CQ) in Italy at center level. Methods Gastroenterologists participating in a nationwide colonoscopy education initiative provided information on structural indicators of t...
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Background & Aims Patients with advanced liver disease often undergo invasive procedures, so the combination of thrombocytopenia, coagulopathy, and bleeding should be carefully assessed. We evaluated the prevalence of thrombocytopenia in a series of patients with liver cirrhosis who were being evaluated for orthotopic liver transplantation (OLT) and determined the number of invasive procedures and procedure-related incidences of bleeding in patients with thrombocytopenia. Methods We studied 121 ...
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