Zhongguo shi yan xue ye xue za zhi · 2026
[Analysis of Predictive Factors for Discontinuation of Hetrombopag in Patients with Chronic Primary Immune Thrombocytopenia].
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Wu Yi, Zhao Jiang-Shan, Liu Xian-Hui
Аннотация
OBJECTIVE: To explore the predictive factors and predictive value for sustained response off treatment (SROT) with hetrombopag in patients with chronic primary immune thrombocytopenia (CITP).
METHODS: A retrospective analysis was conducted on 84 patients diagnosed with CITP who received regular oral hetrombopag for ≥6 months at Henan Provincial Hospital of Traditional Chinese Medicine from August 2020 to May 2025. The follow-up period was 3-15 months. Patients were divided into the SROT group (patients who achieved sustained platelet response after hetrombopag discontinuation, i.e., PLT>30×109/L with no bleeding events for at least 3 months) and the non-SROT group (those who failed to achieve SROT). Factors including ratio of CD4+ to CD8+ T cells, ratio of CD19+ to CD45+ cells, Platelet-to-lymphocyte ratio, duration of drug withdrawal, and TCM syndrome types (Blood-heat agitation syndrome, Yin deficiency with internal heat syndrome, Qi deficiency failing to control blood syndrome, Blood stasis internal obstruction syndrome) were collected. Univariate analysis and binary logistic regression were used to analyze the influencing factors of sustained response off treatment with hetrombopag in CITP patients, and the predictive value was assessed through receiver operating characteristic (ROC) curve analysis.
RESULTS: Among the 84 CITP patients, 40 were assigned to the SROT group and 44 to the non-SROT group. No statistically significant differences were observed in baseline data (ratio of treatment duration to disease duration, bone marrow megakaryocyte count, body mass index, age, and platelet count) between the two groups. Univariate analysis revealed significant differences between the two groups in ratio of CD4+ to CD8+ T cells, ratio of CD19+ to CD45+ cells, duration of drug withdrawal, and TCM syndrome types (Blood-heat agitation syndrome, Yin deficiency with internal heat syndrome). These factors were incorporated into binary logistic regression analysis, which showed that duration of drug withdrawal was a protective factor for achieving SROT (P <0.05), while the ratio of CD19+ to CD45+ cells was a risk factor. ROC curve analysis indicated that the areas under the curve (AUC) of duration of drug withdrawal, ratio of CD19+ to CD45+ cells, and their combined detection for predicting SROT achievement in CITP patients treated with hetrombopag were 0.708, 0.750, and 0.825, respectively. The AUC of combined detection was significantly higher than that of individual detection (P <0.05).
CONCLUSION: Duration of drug withdrawal is a protective factor for achieving SROT in CITP patients receiving hetrombopag, while the ratio of CD19+ to CD45+ cells is a risk factor. Combined detection of drug withdrawal duration and pre-treatment ratio of CD19+ to CD45+ cells has high predictive value for identifying whether CITP patients can achieve SROT after hetrombopag treatment.
METHODS: A retrospective analysis was conducted on 84 patients diagnosed with CITP who received regular oral hetrombopag for ≥6 months at Henan Provincial Hospital of Traditional Chinese Medicine from August 2020 to May 2025. The follow-up period was 3-15 months. Patients were divided into the SROT group (patients who achieved sustained platelet response after hetrombopag discontinuation, i.e., PLT>30×109/L with no bleeding events for at least 3 months) and the non-SROT group (those who failed to achieve SROT). Factors including ratio of CD4+ to CD8+ T cells, ratio of CD19+ to CD45+ cells, Platelet-to-lymphocyte ratio, duration of drug withdrawal, and TCM syndrome types (Blood-heat agitation syndrome, Yin deficiency with internal heat syndrome, Qi deficiency failing to control blood syndrome, Blood stasis internal obstruction syndrome) were collected. Univariate analysis and binary logistic regression were used to analyze the influencing factors of sustained response off treatment with hetrombopag in CITP patients, and the predictive value was assessed through receiver operating characteristic (ROC) curve analysis.
RESULTS: Among the 84 CITP patients, 40 were assigned to the SROT group and 44 to the non-SROT group. No statistically significant differences were observed in baseline data (ratio of treatment duration to disease duration, bone marrow megakaryocyte count, body mass index, age, and platelet count) between the two groups. Univariate analysis revealed significant differences between the two groups in ratio of CD4+ to CD8+ T cells, ratio of CD19+ to CD45+ cells, duration of drug withdrawal, and TCM syndrome types (Blood-heat agitation syndrome, Yin deficiency with internal heat syndrome). These factors were incorporated into binary logistic regression analysis, which showed that duration of drug withdrawal was a protective factor for achieving SROT (P <0.05), while the ratio of CD19+ to CD45+ cells was a risk factor. ROC curve analysis indicated that the areas under the curve (AUC) of duration of drug withdrawal, ratio of CD19+ to CD45+ cells, and their combined detection for predicting SROT achievement in CITP patients treated with hetrombopag were 0.708, 0.750, and 0.825, respectively. The AUC of combined detection was significantly higher than that of individual detection (P <0.05).
CONCLUSION: Duration of drug withdrawal is a protective factor for achieving SROT in CITP patients receiving hetrombopag, while the ratio of CD19+ to CD45+ cells is a risk factor. Combined detection of drug withdrawal duration and pre-treatment ratio of CD19+ to CD45+ cells has high predictive value for identifying whether CITP patients can achieve SROT after hetrombopag treatment.