Promacta for low platelets,

[spectda]

My doctor is trying to get me approved for taking promacta for low platelets (45,000). I've read the warnings. How serious is this stuff? Have we had anyone on the forum that had a serious adverse event from taking it?
Thanks everyone

[HectorSF]

I believe it will be the platelet limits or limits on reducing INF of the trial that are the critical factors.

45 isn't very low, although since you started at 150 that is quite a drop.

During SOC treatment when I got down in the low 20s the docs started to get concerned. I went down in the upper teens (17-19?). At that point my 12 weeks were up after not dropping my viral load more than 2 logs. So being both a non-responder and having platelets in the teens ended my treatment. After a few weeks my platelet level return to norm 70-80 thousand. Norm because I have cirrhosis.

Bleeding was never a problem for me.

I have talked to my hepatologist about treating with the new STAT-C drugs when they come to market. If I do treat she said I would need transfusions to keep my platelets in check during prolonged treatment. I defer to my doctor on this one as having advance cirrhosis and taking a drug with its potential toxic liver effects appears very risky to me.
-----------------------------------------------------------------------------------------------------------------------
[Posted 05/12/2010] GlaxoSmithKline and FDA notified healthcare professionals of a new safety finding in patients with thrombocytopenia due to chronic liver disease treated with eltrombopag, a thrombopoietin receptor agonist approved for the treatment of thrombocytopenia in adult patients with chronic immune (idiopathic) thrombocytopenic purpura.

Action required by Health Care Professionals:

    * Health Care Professionals are reminded that Promacta is indicated for the treatment of thrombocytopenia in adult patients with chronic immune (idiopathic) thrombocytopenic purpura (ITP) and is not indicated for the treatment of thrombocytopenia in patients with chronic liver disease. (!)
    
   * Treatment with Promacta should be aimed at increasing the platelet count to a level that reduces the risk of bleeding; Promacta should not be used in an attempt to normalize the platelet count. (!)
  
    * Use caution when administering Promacta to patients with known risk factors for thromboembolism.
  
    * Exercise caution when administering Promacta to patients with hepatic disease. Use a lower starting dose (25mg once daily) of Promacta in patients with moderate to severe hepatic disease and monitor closely.

Go luck.
Hectorsf

[Bill1954]

Hahahaha!

[spectda]

Look Bill, maybe you and Cando can kiss while I give Susan a big thank you kiss back.
I would be willing to do a group hug with you and Can, but that's it.

Susan-Thanks for the information you provided and your taking time to find it, I will give my lovely wife a big kiss when she gets home.

Can-do-man
Thanks for the information about your being able to go to 25,000 in your trial. I sent my nurse a message mentioning what you went through and asking them to wait to intervene.

I know that my team is very good and will do the best they can for me.

Group hug and a few bars of kumbaya!! - Dave

[Bill1954]

Those are good links, Susan; it’s interesting to look back several years, isn’t it?

Now on an unrelated note; if Dave gets a kiss for being undetectable for a week or so, what’s in it for a guy like me that’s been undetectable for a few years now, huh :)?

--Bill

[portann]

Dave, I'm tied up right now but here are some old threads that may be useful and include comments by some of the current crew. The one to read first is probably this short, significant one:

http://www.medhelp.org/posts/Hepatitis-C/Eltrombopag-platelet-drug-Trial-Halted-/show/1240951


http://www.medhelp.org/posts/Hepatitis-C/For-Hector-SF---ELEVATE-Study/show/773795

and an earlier discussion:

http://www.medhelp.org/posts/Hepatitis-C/Constant-battle-with-platellet-count/show/98732

I remember mikesimon saying he treated with low platelets in the below 30,000 range. Hope he steps in.

In the meantime, must run but sending another kiss for your UND. And one for the wife.

[Bill1954]

Oh, and again; none of these are labeled for HCV therapy, to my knowledge; I'd imagine that would affect insurance coverage, etc...