Thrombocytopenia is a common clinical problem in HCV-infected cases. Multiple studies have consistently shown a rise in platelet count following a successful HCV treatment thus proving a cause-effect relationship between the two. Although, many therapeutic strategies have been tried in the past to treat HCV-related
thrombocytopenia (e.g.
interferon dose reductions, oral
steroids,
intravenous immunoglobulins,
splenectomy etc), the success rates have been variable and not always reproducible. After the cessation of clinical trials of
PEG-rHuMGDF due to immunogenecity issues, the introduction of non-immunogenic second-generation
thrombopoietin-mimetics (
eltrombopag and
Romiplostim) has opened up a novel way to treat HCV-related
thrombocytopenia. Although the data is still sparse,
eltrombopag therapy has shown to successfully achieve the primary endpoint platelet counts of >/=50,000/muL in phase II& III, randomized, double-blind, placebo-controlled trials. Likewise, though it is premature to claim safety of this
drug especially in high-risk patient groups, reported side effects in the published literature were of insufficient severity to require discontinuation of the
drug. Based on the current and emerging evidence, a review of the pharmacologic basis, pharmacokinetics, therapeutic efficacy, safety profile and future considerations of
eltrombopag in the context of HCV-related
thrombocytopenia is given in this article. A MEDLINE search was conducted (1990 to August 2009) using the search terms
eltrombopag, HCV,
thrombocytopenia.