Severe thrombocytopenia in a patient with hepatitis C treated with eltrombopag from off-label drug use to on-label drug use: a case report

Journal of Medical Case Reports

Khalifa Al-Banwan¹  Ahmad Alduaij³  Jameela Al-Khaldi²  Hassan A Al-Jafar⁴ 

[1] Microbiology Department, Amiri Hospital, Gulf Street, Kuwait City, Kuwait;Gastroenterology Department, Amiri Hospital, Gulf Street, Kuwait City, Kuwait;Histopathology Department, Amiri Hospital, Gulf Street, Kuwait City, Kuwait;Hematology Department, Amiri Hospital, Gulf Street, Kuwait City, Kuwait

关键词: Eltrombopag;    Thrombocytopenia;    Peginterferon;    Off-label drug use;    Hepatitis C virus;   

Others  :  1181049
DOI  :  10.1186/1752-1947-8-303

 received in 2014-02-18, accepted in 2014-07-14,  发布年份 2014

【 摘 要 】

Introduction

Off-label drug use refers to drug use beyond the specifications authorized for marketing. Eltrombopag is a new thrombopoietin receptor agonist which was used successfully in this critical case of thrombocytopenia associated with hepatitis C infection before it became an approved drug for such cases.

Case presentation

A 56-year-old Kuwaiti woman with hepatitis C virus infection was treated with pegylated interferon α-2a and ribavirin, laboratory test results prior to therapy were within normal values. After 4 weeks of that treatment, she developed neutropenia and severe thrombocytopenia. Her hepatitis C virus treatment was stopped for many years until eltrombopag was used as an off-label drug with an episode of severe thrombocytopenia. Her platelets count returned to normal level when triple therapy for hepatitis C virus was used successfully.

Conclusions

An off-label drug should be used only when it is the best available drug, based on evidence from on-going multicenter trials. It could be life saving for some patients in critical situations. However, clinical use of eltrombopag later confirmed that it is a safe and effective drug for immune thrombocytopenic purpura or thrombocytopenia associated with hepatitis C virus infection.

【 授权许可】

   
2014 Al-Jafar et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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