Can avatrombopag (Sucoxin) treat thrombocytopenia associated with chronic liver disease?

Avatrombopag is an oral thrombopoietin receptor agonist (TPO-RA) that stimulates the proliferation and maturation of megakaryocytes in the bone marrow, thereby increasing the number of platelets. One of the original purposes of the development of this drug is to increase platelets in patients with chronic liver disease before undergoing invasive procedures, so it has a clear therapeutic effect on thrombocytopenia related to chronic liver disease. Compared with traditional platelet transfusion, avatrombopag can increase platelet levels in advance, safely and stably, reducing the need for blood transfusions for patients.

In patients with chronic liver disease, thrombocytopenia is very common due to portal hypertension, hypersplenism, and decreased hepatic synthetic function. Avatrombopag does not rely on the liver enzyme system for its main metabolism, so it still has good safety and predictable plate-raising effects in patients with hepatic insufficiency. Clinical studies show that after taking the drug, platelets generally start to increase at 5–8 days and reach a peak about 10–13 days. It can effectively help patients reduce the risk of bleeding when undergoing punctures, endoscopy or other invasive procedures.

Compared with otherTPO-RA, avatrombopag does not need to be taken on an empty stomach and does not significantly increase the risk of portal vein thrombosis, which is a significant advantage. In clinical trials, the platelet rise curve of avatrombopag in patients with chronic liver disease was relatively stable, and the incidence of adverse reactions was low. Common discomforts such as headache, fatigue or mild gastrointestinal reactions were mostly short-lived and could be relieved on their own. Doctors usually develop a short-course dosing regimen based on the patient's baseline platelet value for plate management before surgery. For some cases that require long-term platelet elevation, there are also studies exploring the feasibility of continuous treatment.

In summary, avatrombopag is currently one of the first-line oral drugs that can be clearly used for thrombocytopenia related to chronic liver disease, especially for patients who require invasive procedures but have low platelets. Whether it is necessary to use it and how to formulate a course of treatment should be comprehensively evaluated based on the baseline platelet level, liver disease stage, surgical risk level, and previous treatment response. Proper use under the guidance of a professional doctor can usually safely and effectively increase platelets and reduce the risk of bleeding.

Reference materials:https://www.drugs.com/