Key Points
Early thrombopoietin receptor agonist (TPO-RA) initiation may reduce prednisolone dose and treatment duration in Japanese real-world data.
Early TPO-RA initiation may reduce corticosteroid-related adverse events such as hypertension and insulin-dependent diabetes.
Abstract
This longitudinal, descriptive study investigated the effect of the timing of thrombopoietin receptor agonist (TPO-RA) initiation on corticosteroid administration and related adverse events (AEs) in patients with immune thrombocytopenia (ITP) in Japan using real-world data from a health claims database. In total, 7,696 patients were divided into three groups (Early TPO-RA initiation, Late TPO-RA initiation, and Non-TPO-RA administration) by the presence and timing of TPO-RA administration. The Early TPO-RA initiation group included patients first administered TPO-RA less than 60/120/180 days after the Index Date. The Late TPO-RA initiation group included patients first administered TPO-RA more than 60/120/180 days after the Index Date. The Early TPO-RA initiation group received the highest daily average prednisolone dose, followed by a rapid decrease in dose, similar to that in the Non-TPO-RA administration group. In the Early TPO-RA initiation group, there was a long-term trend toward daily average prednisolone doses of ≤5 mg, and by approximately 10–11 months, the median dose was 0 mg. Diabetes (insulin-dependent) and hypertension tended to occur more frequently in the Late TPO-RA (8.4% and 19.9%, respectively) than in the Early TPO-RA initiation groups (6.9% and 14.4%, respectively). Incidence rates of infections in the Late TPO-RA and Early TPO-RA initiation groups were similar (7.2% vs. 7.6%). The incidence of AEs was similar between male and female patients, a trend toward a higher incidence observed in those aged ≥60 years. Early initiation of TPO-RA administration can contribute to reducing total prednisolone dosage, treatment duration, and AEs (e.g., hypertension and insulin-dependent diabetes).
Author notes
Data Sharing Statement: The dataset used in this study can be purchased from MDV; the authors cannot share the data with third parties or make them available to the public. However, researchers who meet access criteria may obtain the de-identified data from MDV.
