The Medical Letter on Drugs and Therapeutics
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1305
Two New Drugs for Chronic ITP
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Romiplostim (Nplate – Amgen), a recombinant fusion protein injected subcutaneously, and eltrombopag (Promacta – GlaxoSmithKline), a non-peptide taken orally, have been approved by the FDA for treatment of chronic immune thrombocytopenic purpura (ITP) refractory to corticosteroids, immunoglobulins and/or splenectomy.

MECHANISM OF ACTION — ITP has traditionally been attributed to antibody-mediated peripheral platelet destruction, but impaired platelet production is now known to play a role as well. Thrombopoietin values are normal or low in most patients with ITP. Romiplostim and eltrombopag have no structural resemblance to thrombopoietin, but they both bind to and activate the human thrombopoietin receptor, stimulating megakaryocyte development and platelet production. Unlike romiplostim, eltrombopag does not compete for the same binding site as endogenous ... more      

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Title: Two New Drugs for Chronic ITP
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