Eltrombopag

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Eltrombopag
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Systematic (IUPAC) name
3'-{(2Z)-2-[1-(3,4-dimethylphenyl)-3-methyl-5-oxo-1,5-dihydro-4H-pyrazol-4-ylidene]hydrazino}-2'-hydroxy-3-biphenylcarboxylic acid
Identifiers
CAS number 496775-61-2
496775-62-3 (olamine)
ATC code B02BX05
PubChem CID 9846180
Chemical data
Formula C25H22N4O4 
Mol. mass 442.467 g/mol
SMILES eMolecules & PubChem
Therapeutic considerations
Licence data US FDA:link
Pregnancy cat.  ?
Legal status  ?
Routes Oral

Eltrombopag (rINN, codenamed SB-497115-GR) is a medication that has been developed for conditions that lead to thrombocytopenia (abnormally low platelet counts). It is a small molecule agonist of the c-mpl (TpoR) receptor, which is the physiological target of the hormone thrombopoietin. Eltrombopag was discovered as a result of research collaboration between GlaxoSmithKline and Ligand Pharmaceuticals. Designated an orphan drug in the USA and European Union, it is being manufactured and marketed by GlaxoSmithKline under the trade name Promacta in the USA and will be marketed as Revolade in the EU. Eltrombopag was approved by the U.S. Food and Drug Administration on November 20, 2008. [1]

Development

In preclinical studies, the compound was shown to interact selectively with the thrombopoeitin receptor, leading to activation of the JAK-STAT signaling pathway and increased proliferation and differentiation of megakaryocytes. Animal studies confirmed that administration could increase platelet counts. In 73 healthy volunteers, higher doses of eltrombopag caused larger increases in the number of circulating platelets without tolerability problems.[2]

Clinical trials

Eltrombopag has been studied, and shown to be effective, in two major clinical syndromes: idiopathic thrombocytopenic purpura[3] and cirrhosis due to hepatitis C (in which low platelet counts may be a contraindication for interferon treatment).[4] After 6 weeks of therapy in a phase III trial, eltrombopag 50mg/day was associted with a significantly higher resonse rate than placebo in adult patients with chronic ITP.[5]

References

  1. Template:Cite press release
  2. Jenkins JM, Williams D, Deng Y, et al. (2007). "Phase 1 clinical study of eltrombopag, an oral, nonpeptide thrombopoietin receptor agonist". Blood 109 (11): 4739–41. doi:10.1182/blood-2006-11-057968. PMID 17327409. http://bloodjournal.hematologylibrary.org/cgi/content/full/109/11/4739. 
  3. Bussel JB, Cheng G, Saleh MN, et al. (2007). [Expression error: Missing operand for > "Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura"]. N. Engl. J. Med. 357 (22): 2237–2247. doi:10.1056/NEJMoa073275. PMID 18046028. 
  4. McHutchison JG, Dusheiko G, Shiffman ML (2007). [Expression error: Missing operand for > "Eltrombopag for thrombocytopenia in patients with cirrhosis associated with hepatitis C"]. N. Engl. J. Med. 357 (22): 2227–2236. doi:10.1056/NEJMoa073255. PMID 18046027. 
  5. Garnock-Jones KP, Keam SJ.[1].Drugs 2009;69(5):567-576.doi: 10.2165/00003495-200969050-00005.

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