Dr. Engel on the Use of Eltrombopag in HIV-Related Thrombocytopenia

Elissa Engel, MD, pediatric resident, University of South Florida, discusses the successful use of eltrombopag (Promacta) in a pediatric patient with HIV-related thrombocytopenia.

A 13-year old patient presented with HIV, which Engel says was most likely acquired prenatally. The patient was treated with first-line therapies including intravenous immunoglobulin (IVIg), but had poor response. After 2 years, the patient required treatment every 3 to 4 weeks, showed response, but then had symptomatic thrombocytopenia.

To treat the thrombocytopenia, Engel and her colleagues decided to treat the patient with eltrombopag based on information gathered from previous literature on the agent. Eltrombopag was dosed at 50 mg per day. The patient showed a clinical response, and has remained asymptomatic since starting the medication. This may imply that eltromopag can be used in patients who do not respond to first-line therapy, Engel says.