What are the adverse reactions of fostatinib/fotantinib?

As an oral drug targeting spleen tyrosine kinase, fostamatinib (Fostamatinib) not only brings therapeutic benefits, but also has a certain spectrum of adverse reactions. Overseas drug instructions and clinical application experience show that the overall adverse reactions are mainly manageable, but the basic conditions of patients with chronic immune thrombocytopenia (ITP) still need to be fully assessed before medication, and dynamic monitoring is carried out during the treatment process.

In terms of the digestive system, diarrhea is one of the more common adverse reactions, which usually occurs at the beginning of medication or during the dosage adjustment stage. Most patients present with mild to moderate symptoms, which can be gradually relieved through dietary adjustment, symptomatic treatment or short-term dose adjustment. Some patients may also experience nausea, abdominal discomfort or loss of appetite, and these reactions tend to stabilize after continued medication. Overseas clinical experience emphasizes that early identification and intervention can help improve patients' long-term tolerance.

In terms of metabolic and cardiovascular-related reactions, elevated blood pressure and fluctuations in liver function indicators are the focus of clinical attention. Some patients may experience an increase in blood pressure while taking fostatinib, so patients with a history of hypertension need to be closely monitored. Elevated liver enzymes are mostly reversible changes and can usually be managed safely by regularly checking liver function and adjusting dosage based on the results. This is also an important reason why standardized follow-up is repeatedly emphasized in overseas guidelines.

In addition, some patients may experience mild headache, fatigue, or upper respiratory tract infection-like symptoms, reactions that are not uncommon with similar immune-related treatments. In general, the adverse reactions of fostatinib are not mainly characterized by severe myelosuppression or obvious immunosuppression, which gives it certain advantages in some patients who are intolerant to traditional immunosuppressive drugs.

Judging from long-term drug use observations overseas, most adverse reactions are predictable and controllable as long as the starting dose is reasonable and adjusted step by step under the guidance of a doctor, as well as necessary laboratory monitoring.

Reference materials:https://go.drugbank.com/drugs/DB12010