Abstract
Lusutrombopag (Mulpleta®) is an orally bioavailable, small molecule thrombopoietin (TPO) receptor agonist being developed by Shionogi for chronic liver disease (CLD) patients with thrombocytopenia prior to elective invasive surgery. Lusutrombopag acts selectively on the human TPO receptor and activates signal transduction pathways that promote the proliferation and differentiation of bone marrow cells into megakaryocytes, thereby increasing platelet levels. In September 2015, lusutrombopag received its first global approval in Japan for the improvement of CLD-associated thrombocytopenia in patients scheduled to undergo elective invasive procedures. This article summarizes the milestones in the development of lusutrombopag leading to this first approval.
Similar content being viewed by others
References
Afdhal N, McHutchison J, Brown R, et al. Thrombocytopenia associated with chronic liver disease. J Hepatol. 2008;48(6):1000–7.
Maan R, de Knegt RJ, Veldt BJ. Management of thrombocytopenia in chronic liver disease: focus on pharmacotherapeutic strategies. Drugs. 2015. doi:10.1007/s40265-015-0480-0.
Poordad F. Review article: thrombocytopenia in chronic liver disease. Aliment Pharmacol Ther. 2007;26(Suppl 1):5–11.
European Medicines Agency. Revolade (eltrombopag) film-coated tablets. 2015. http://www.ema.europa.eu/ema/. Accessed 1 Dec 2015.
US FDA. Promacta (eltrombopag) tablets: US prescribing information. 2015. http://www.fda.gov. Accessed 1 Dec 2015.
Garnock-Jones KP. Eltrombopag: a review of its use in treatment-refractory chronic primary immune thrombocytopenia. Drugs. 2011;71(10):1333–53.
McCormack PL. Eltrombopag: a review of its use in patients with severe aplastic anaemia. Drugs. 2015;75(5):525–31.
Burness CB. Eltrombopag: a review of its use in the treatment of thrombocytopenia in patients with chronic hepatitis C. Drugs. 2014;74(16):1961–71.
Pharmaceuticals and Medical Devices Agency. Mulpleta® (lusutrombopag) tablets: Japanese prescribing information (in Japanese). 2015. https://www.pmda.go.jp/. Accessed 3 Nov 2015.
Shionogi. Shionogi receives marketing and manufacturing approval in Japan for MULPLETA® tablets 3 mg for improvement of thrombocytopenia [media release]. 28 Sep 2015. http://www.shionogi.co.jp/en/.
Adis Insight. Drug profile: lusutrombopag. 2015. http://adisinsight.springer.com. Accessed 1 Dec 2015.
Katsube T, Ishibashi T, Kano T, et al. Population PK/PD modeling of lusutrombopag, thrombopoietin receptor agonist, in healthy volunteers for exploring PK/PD covariates [abstract no. 3059 plus poster]. In: Annual meeting of the Population Approach Group in Europe; 2014.
Izumi N, Osaki Y, Yamamoto K, et al. A phase 3, randomized, double-blind, placebo-controlled study of lusutrombopag for thrombocytopenia in patients with chronic liver disease undergoing elective invasive procedures in Japan (L-PLUS 1) [abstract no. LB-30]. In: The AASLD liver meeting; 2015.
Izumi N, Tateishi R, Seike M, et al. Once-daily oral lusutrombopag, alternative to platelet transfusion in thrombocytopenic patients with chronic liver disease undergoing radiofrequency ablation: Results from a phase 2b, randomized, double-blind study [abstract no. P933]. J Hepatol. 2014;60(Suppl 1):S386.
Shionogi. Research and development at Shionogi (March 18, 2015). 2015. http://www.shionogi.co.jp/en/ir/library/explanatory.html. Accessed 1 Dec 2015.
Nguyen TTL, Palmaro A, Montastruc F, et al. Signal for thrombosis with eltrombopag and romiplostim: a disproportionality analysis of spontaneous reports within VigiBase. Drug Saf. 2015;38(12):1179–86.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The preparation of this review was not supported by any external funding. During the peer review process the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes resulting from any comments received were made by the author on the basis of scientific completeness and accuracy. E. S. Kim is a salaried employee of Adis, Springer SBM.
Additional information
This profile has been extracted and modified from the AdisInsight database. AdisInsight tracks drug development worldwide through the entire development process, from discovery, through pre-clinical and clinical studies to market launch and beyond.
Rights and permissions
About this article
Cite this article
Kim, E.S. Lusutrombopag: First Global Approval. Drugs 76, 155–158 (2016). https://doi.org/10.1007/s40265-015-0525-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40265-015-0525-4