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Eltrombopag: A Review of Its Use in Patients with Systemic Lupus Erythematosus Associated Immune Thrombocytopenia

Waniot Iva, Ana Eash

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that primarily affects young women of childbearing age. Thrombocytopenia is a relatively common hematologic manifestation of SLE, occurring in approximately 20-30% of SLE patients. The etiology of SLE thrombocytopenia is primarily autoimmune mediated and classified as Immune thrombocytopenia (ITP). Studies have shown that mortality is significantly higher in SLE patients with thrombocytopenia than non-thrombocytopenic patients. The mortality rate of patients in complete remission after treatment is significantly lower than that of patients in incomplete remission. Therefore, complete recovery from thrombocytopenia is important for the survival of patients with SLE. Eltrombopag is an oral Thrombopoietin Receptor (TPO-R) agonist that promotes the proliferation and differentiation of multifetal hematopoietic stem cells and megakaryocyte progenitors. It is also involved in megakaryocyte survival and anti-apoptosis, thereby increasing platelet production. Compared to conventional treatment modalities, Eltrombopag often allows patients to achieve complete remission, and the adverse effects are usually mild and reversible, especially in patients with refractory SLEassociated ITP (SLE-ITP). In conclusion, eltrombopag is a promising and safe option for the treatment of SLE-ITP because of its efficacy and ability to help reduce the dose of steroids and immunosuppressants when combined with other drugs.