National Institute for Health and Care Excellence (NICE) has recommended lusutrombopag (Mulpleo) as a treatment option for severe thrombocytopenia associated with chronic liver disease.
Lusutrombopag is recommended for treatment of severe thrombocytopenia (platelet count, <50,000 platelets/µL of blood) in adults with chronic liver disease having planned invasive procedures.
Recommended dose for lusutrombopag is 3 mg once daily orally for seven days. The procedure should be performed from day 9 after initiating lusutrombopag. Platelet count should be assessed prior to the procedure.
Patients with chronic liver disease often have thrombocytopenia, which increases their likelihood of bleeding during invasive procedures including surgeries. The current standard of care involves administering a platelet transfusion before the procedure to minimize the bleeding risk.
The use of lusutrombopag is associated with several benefits, such as:
- need for fewer transfusions;
- fewer hospital stays; and
- lower risk for transfusion-related complications.
Evidence from a clinical trial showed that fewer patients required a platelet transfusion if they were treated with lusutrombopag compared with a placebo treatment; however, there is no evidence of survival with lusutrombopag over platelet transfusions.
