In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation by Bethan Psaila, James B. Bussel, Matthew.

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In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation by Bethan Psaila, James B. Bussel, Matthew D. Linden, Bracken Babula, Youfu Li, Marc R. Barnard, Chinara Tate, Kanika Mathur, Andrew L. Frelinger, and Alan D. Michelson Blood Volume 119(17):4066-4072 April 26, 2012 ©2012 by American Society of Hematology

Platelet parameters in healthy controls and in patients with ITP at 0, 7, and 28 days of eltrombopag treatment. Platelet parameters in healthy controls and in patients with ITP at 0, 7, and 28 days of eltrombopag treatment. (A) Platelet count, (B) mean platelet volume (MPV), (C) immature platelet fraction (IPF) %, and (D) absolute immature platelet fraction (AIPF). Data are mean ± SEM (*P < .05; **P < .02; ***P < .001). Bethan Psaila et al. Blood 2012;119:4066-4072 ©2012 by American Society of Hematology

Platelet parameters in responders to eltrombopag treatment. Platelet parameters in responders to eltrombopag treatment. (A) Platelet count, (B) mean platelet volume (MPV), (C) immature platelet fraction (IPF) %, and (D) absolute immature platelet fraction (AIPF). Responders (black columns) and nonresponders (gray columns). Data are mean ± SEM (*P < .05; **P < .02; ***P < .001). Bethan Psaila et al. Blood 2012;119:4066-4072 ©2012 by American Society of Hematology

Platelet surface expression of activation markers in controls and ITP patients at days 0, 7, and 28 of eltrombopag treatment with no added agonist and in response to low and high dose ADP and TRAP stimulation. Platelet surface expression of activation markers in controls and ITP patients at days 0, 7, and 28 of eltrombopag treatment with no added agonist and in response to low and high dose ADP and TRAP stimulation. (A) Activated GPIIb/IIIa (PAC-1), (B) P-selectin, and (C) GPIb. C indicates healthy controls; D0, ITP patients pretreatment with eltrombopag; and D7 and D28, 7 and 28 days after initiation of eltrombopag treatment in ITP patients. Black-capped bars indicate unpaired (ITP at baseline vs controls) and gray bars indicate pairwise comparisons (ITP patients at different study days). Data are mean ± SEM (*P < .05; **P < .02; ***P < .001). Bethan Psaila et al. Blood 2012;119:4066-4072 ©2012 by American Society of Hematology

Platelet surface markers of activation in responders and nonresponders to eltrombopag treatment with no added agonist and in response to low and high dose ADP and TRAP stimulation. Platelet surface markers of activation in responders and nonresponders to eltrombopag treatment with no added agonist and in response to low and high dose ADP and TRAP stimulation. (A-C) Responders and (D-F) nonresponders. (A,D) Activated GPIIb/IIIa (PAC-1), (B,E) P-selectin, and (C,F) GPIb. C indicates healthy controls; D0, ITP patients pretreatment with eltrombopag; D7 and D28, 7 and 28 days after initiation of eltrombopag treatment in ITP patients. Data are mean ± SEM (*P < .05; **P < .02; ***P < .001). Bethan Psaila et al. Blood 2012;119:4066-4072 ©2012 by American Society of Hematology

Platelet surface markers of activation in controls following in vitro manipulation of platelet counts. Platelet surface markers of activation in controls following in vitro manipulation of platelet counts. (A) Activated GPIIb/IIIa, (B) P-selectin, and (C) GPIb. Data are mean ± SEM, n = 5 (*P < .05, **P < .02) for agonist-induced platelet integrin expression in thrombocytopenic samples compared with that at “normal” platelet counts (ie, 175 × 109/L). Bethan Psaila et al. Blood 2012;119:4066-4072 ©2012 by American Society of Hematology