ABSTRACT
Objectives: We aimed to investigate the safety and effectiveness of eltrombopag for adult patients with refractory immune thrombocytopenia (ITP) secondary to connective tissue disease (CTD). Methods: This is a single-centre, retrospective cohort and propensity score-matched study. Data from CTD-ITP patients treated with eltrombopag between January 2019 and January 2023 were retrospectively analysed. Baseline characteristics and follow-up information were recorded. CTD patients without ITP were matched to identify the risk factors associated with CTD-ITP performed by Logistic regression analysis. Results: Twenty patients were enrolled, including 5 systemic lupus erythematosus (SLE), 9 Sjögren's syndrome (SS) and 6 undifferentiated connective tissue disease (UCTD). Nineteen (95%) patients were female, and the median age was 59 years. Logistic regression analysis showed that anaemia (OR = 8.832, P = 0.007) was associated with increased risk of ITP, while non-erosive arthritis (OR = 0.045, P = 0.001) and interstitial lung disease (OR = 0.075, P = 0.031) were associated with reduced risk. Fourteen patients (70%) achieved a complete response (CR) and one (5%) achieved a partial response (PR). The median response time was 14 days. The median platelet count was 8.5 × 109/l at baseline of eltrombopag and increased to 122 × 109/l after 4 weeks. No adverse events were observed. Conclusions: Eltrombopag appears to be effective, safe and well-tolerated in refractory ITP patients with CTD; larger studies are needed to confirm the generalizability of these findings.
ABSTRACT
AIM: The aim of this study was to assess the effect of pentoxifylline on proteinuria and renal function in chronic kidney disease (CKD) treatment. METHODS: We systematically searched PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov for randomized and non-randomized controlled trials comparing pentoxifylline to placebo, no treatment or renin-angiotensin system blockade in proteinuric CKD patients. The outcomes concerning proteinuria, renal function, blood pressure and adverse events were extracted. RESULTS: Twelve trials with 613 participants were identified. Pentoxifylline significantly decreased proteinuria [weighted mean difference (WMD) -0.60 g/day (95 % CI -0.84 to -0.36); p < 0.001] compared to placebo or no-treatment groups, but the decrease was not significant [WMD: 0.10 g/day (-0.34 to 0.54); p = 0.66] compared to captopril treatment. The decrease of glomerular filtration rate was significantly less [WMD: 3.67 ml/min (2.71-4.62); p < 0.001] in the pentoxifylline group than in the controls. There was no significant difference in serum creatinine [WMD: -0.03 mg/dl (-0.10 to 0.03); p = 0.28], diastolic blood pressure [WMD: 0.94 mmHg (-0.74 to 2.61); p = 0.27] and adverse events [RR: 0.89 (0.60 to 1.32); p = 0.56]. CONCLUSIONS: Pentoxifylline may decrease proteinuria and protect renal function in patients with CKD. Further studies are needed to confirm this result.
