Interleukin-11 for Treatment of Hepatitis C-Associated ITP

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Abstract
Background: Immune thrombocytopenic purpura (ITP) is frequently associated with chronic hepatitis C (HpC-ITP). Methods: Recombinant interleukin-11 (rIL-11), which has both thrombopoietic and anti-inflammatory properties, was evaluated in 12 patients with HpC-ITP in this pilot study. Group 1 (7 patients) was treated at high dose (50 µg/kg daily) while group 2 (5 patients) at low dose (15–35 µg/kg three/week). Results: In group 1, mean platelet counts rose from initial 54 × 109/l to 103 × 109/l (p = 0.02) and in group 2, from an initial 51 × 109/l to 74 × 109/l (p = 0.04). Antiplatelet antibody (aPlt-Ab) decreased in group 1. LFT improved in both groups. The mean HCV-RNA decreased in group 1 (p = 0.04), not in group 2. Side effects were common and troublesome, but were minimized with individualized dosing. One patient achieved good remission of both ITP and HpC lasting >2 years with low-dose maintenance. Conclusion: When used based on individual tolerance, rIL-11 appears useful in HpC-ITP.

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