Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Initial Romiplostim Dosing in ITP Evaluated

J Oncol Pharm Pract; ePub 2018 Jan 1; DasGupta, et al

Higher initial romiplostim dose appears to shorten time to platelet response and hospital length of stay, researchers concluded after conducting a retrospective, single-center, cohort study involving 18 individuals. Participants were hospitalized with corticosteroid- and intravenous immunoglobulin-refractory immune thrombocytopenia. They received initial romiplostim dose of either 1 mcg/kg/week (n=4) or ≥2 mcg/kg/week (n=18). Among the results:

  • Patients in the higher dose group received a median dose of 4.5 mcg/kg/week.
  • Platelets reached ≥10 × 109/L in a median of 2 days in this contingent, vs 4.5 days in the lower-dose group.
  • 43% of patients in the higher-dose group reached platelet ≥30 × 109/L, vs one-fourth of those in the lower-dose cohort.
  • Platelet ≥50 × 109/L was achieved in 28% and 25%, respectively.
  • Median hospital lengths of stay were 13.5 and 20 days, respectively.
  • Nonmajor bleeding events occurred in 29% and 75%, respectively.
  • Major bleeding events occurred in 14% and 0%, respectively.
  • No thrombotic events were seen.


DasGupta R, Levine L, Wiczer T, Cataland S. Initial romiplostim dosing and time to platelet response in patients with treatment refractory immune thrombocytopenia. [Published online ahead of print January 1, 2018]. J Oncol Pharm Pract. doi:10.1177/1078155217748470.