Avatrombopag maleate for the treatment of periprocedural thrombocytopenia in patients with chronic liver disease

Drugs Today (Barc). 2018 Nov;54(11):647-655. doi: 10.1358/dot.2018.54.11.2899441.

Abstract

Avatrombopag maleate (Doptelet; Dova Pharmaceuticals) is an oral, small-molecule second-generation thrombopoietin (TPO) receptor agonist under development for the treatment of thrombocytopenia. Recently approved by the U.S. Food and Drug Administration (FDA) for the treatment of periprocedural thrombocytopenia in patients with chronic liver disease on the basis of the results of two phase III trials, it is currently under investigation for treatment of immune thrombocytopenia (two randomized trials demonstrating efficacy have already been completed), chemotherapy-induced thrombocytopenia and perioperative thrombocytopenia in patients undergoing major surgical procedures. This review will evaluate the preclinical pharmacology, pharmacokinetics, clinical studies, safety, indications and drug interactions of avatrombopag, with a focus on its use for the treatment of periprocedural thrombocytopenia in patients with chronic liver disease.

Keywords: AKR-501; Antithrombocytopenic agents; Avatrombopag maleate; Bleeding; Chronic liver disease; Platelet disorders; Surgery; Thrombocytopenia; Thrombopoietin receptor agonists.

Publication types

  • Review

MeSH terms

  • Animals
  • Chronic Disease
  • Drug Interactions
  • Hematologic Agents / administration & dosage*
  • Hematologic Agents / adverse effects
  • Hematologic Agents / pharmacokinetics
  • Humans
  • Liver Diseases / blood
  • Liver Diseases / diagnosis
  • Liver Diseases / surgery*
  • Perioperative Period
  • Thiazoles / administration & dosage*
  • Thiazoles / adverse effects
  • Thiazoles / pharmacokinetics
  • Thiophenes / administration & dosage*
  • Thiophenes / adverse effects
  • Thiophenes / pharmacokinetics
  • Thrombocytopenia / blood
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / drug therapy*
  • Treatment Outcome

Substances

  • Hematologic Agents
  • Thiazoles
  • Thiophenes
  • avatrombopag