ITP: DUAL UNDERLYING MECHANISMS

ITP is associated with both increased platelet destruction and decreased platelet production.^1–4

Increased platelet destruction:

• Antiplatelet autoantibodies^1–4
• Autoreactive T cells^1–3

Decreased platelet production:

• Insufficient TPO^1–3
• Autoantibody or T cell-mediated megakaryocyte suppression^1–3

Current immunosuppressive therapies used for ITP have non-specific actions to reduce the rate of platelet destruction.¹ In doing so, these actions combat ITP by minimising the ‘increased platelet destruction’ pathway, however they also act with collateral damage by suppressing the normal function of the immune system.^1–3

HOW DOES REVOLADE WORK?

REVOLADE acts in the bone marrow by mimicking the actions of the natural hormone responsible for stimulating platelet production, known as thrombopoietin.^2,3 This in turn increases platelet production. The increase in platelet production induced by REVOLADE helps to compensate for low platelet concentration, helping to reduce the risk of bruising and bleeding. Unlike immunosuppressive therapies, REVOLADE is specific for what it does and it will not interfere with the normal functioning of the immune system.^1,5,6

REVOLADE DIFFERS FROM INJECTABLE LARGE-MOLECULE TPO-RAs^6-8

REVOLADE, unlike larger TPO-RAs:

• Complements endogenous TPO activity^6,8
• Does not promote neutralising antibodies^6,8
• Mimics endogenous TPO production with once-daily oral dosing^7,8

Abbreviations: ITP, immune thrombocytopenia; TPO, thrombopoietin; TPO-RA, thrombopoietin-receptor agonist.

References

1. McCrae K. Cleve Clin J Med. 2011;78(6):358–373.
2. Lambert MP, Gernsheimer TB. Blood. 2017;129(21):2829–2835.
3. Kashiwagi H, Tomiyama Y. Int J Hematol. 2013;98(1):24–33.
4. Yazdanbakhsh K. Blood. 2016;128(6):750–751.
5. REVOLADE Summary of Product Characteristics.
6. Kuter DJ. Int J Hematol. 2013;98(1):10–23.
7. Khellaf M, et al. Haematologica. 2013;98(6):881–887.
8. Romiplostim Summary of Product Characteristics.