芦曲泊帕治疗慢性肝病血小板减少症的临床研究进展

Clinical research progress of lusutrombopag for the treatment of thrombocytopenia in chronic liver disease

血小板减少症是慢性肝病患者常见的累及血液系统的并发症之一,往往造成患者生活质量差、出血风险高,影响其诊疗效果和预后。输注血小板在一定程度上能够改善患者血小板计数下降情况,但其存在价格高昂、易引起机体免疫排斥反应等问题。血小板生成素(TPO)作为影响血小板生成的重要细胞因子,能与TPO受体结合,激活巨核细胞产生血小板。芦曲泊帕是新近研发的小分子TPO受体激动剂,可诱导骨髓祖细胞向巨核细胞分化,增加血小板生成,具有口服方便、安全有效等特点,现已在多个国家和地区的慢性肝病并发的血小板减少症患者中应用。现就其药理作用特点、临床研究进行综述。

Thrombocytopenia is one of the common complications with the hematologic system in patients with chronic liver disease,which often causes poor quality of life and high risk of bleeding,thereby affecting their diagnosis,treatment,and prognosis.Platelet transfusion can improve the patient's declining platelet count to a certain extent,but it has problems such as high price and being easy to cause immune rejection.Thrombopoietin(TPO),as an important cytokine that affects platelet production,can bind to TPO receptors and activate megakaryocytes to produce platelets.Lusutrombopag is a newly developed small-molecule TPO receptor agonist that can induce bone marrow progenitor cells to differentiate into megakaryocytes and increase platelet production,posing characteristics of oral convenience,safety and effectiveness;thus,it has been used in many countries and regions for the treatment of patients with chronic liver diseases concurrent with thrombocytopenia.Herein,the pharmacological features and clinical research are reviewed.