{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:16:36Z","timestamp":1773422196701,"version":"3.50.1"},"reference-count":66,"publisher":"American Veterinary Medical Association (AVMA)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and tolerability of eltrombopag in dogs diagnosed with primary immune-mediated thrombocytopenia (pITP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records from dogs diagnosed with pITP between January 2018 and March 2024 were retrospectively reviewed. Data collected included signalment, presenting signs, diagnostic findings, duration of hospitalization, time to platelet recovery (defined as days to achieve a platelet count \u2265 100,000\/\u03bcL, with no evidence of bleeding), mortality, relapse incidence, transfusion requirements, and adverse events. Dogs were included if they received a combination of corticosteroids, vincristine, mycophenolate mofetil, and human immunoglobulin, with or without the addition of oral eltrombopag administered within 24 hours of diagnosis. Dogs were grouped on the basis of whether they did or did not receive eltrombopag (eltrombopag group vs control group), and results were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>18 dogs met the inclusion criteria (control group, n = 13; eltrombopag group, 5). Median time to platelet recovery, hospitalization, transfusion needs, and mortality did not differ significantly between groups. Eltrombopag was well tolerated, and adverse events, primarily gastrointestinal, were less frequent in the eltrombopag group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Eltrombopag was well tolerated as part of a multimodal treatment protocol for pITP in dogs. However, it was not associated with improved platelet recovery, shorter hospitalization, or reduced mortality compared with standard therapy alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>This study provided evidence that eltrombopag may be safely incorporated into immunosuppressive regimens for canine pITP; however, its clinical benefit remains uncertain. Further research is required to determine its role in optimizing treatment for ITP in dogs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.07.0483","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T14:32:14Z","timestamp":1761748334000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Eltrombopag is well tolerated but provides no additional benefit in the treatment of canine primary immune-mediated thrombocytopenia"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2920-7171","authenticated-orcid":true,"given":"Jeongmin","family":"Lee","sequence":"first","affiliation":[{"name":"Korea Animal Medical Center, Cheongju, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seungkeun","family":"Lee","sequence":"additional","affiliation":[{"name":"Korea Animal Medical Center, Cheongju, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihyun","family":"Han","sequence":"additional","affiliation":[{"name":"Korea Animal Medical Center, Cheongju, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So Young","family":"Park","sequence":"additional","affiliation":[{"name":"Korea Animal Medical Center, Cheongju, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeon Ju","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea Animal Medical Center, Cheongju, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-2035","authenticated-orcid":true,"given":"Kun-Ho","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2252-293X","authenticated-orcid":true,"given":"Mi-Kyung","family":"Park","sequence":"additional","affiliation":[{"name":"Research Institute of Veterinary Medicine, Chungnam National University, Daejeon, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"21","key":"ref1","series-title":"Vet Rec","first-page":"647","article-title":"Retrospective study of 871 dogs with thrombocytopenia","volume":"164","author":"Botsch V","year":"2009","unstructured":"Botsch V, K\u00fcchenhoff H, Hartmann K, Hirschberger J. Retrospective study of 871 dogs with thrombocytopenia. Vet Rec. 2009;23:164(21):647-651. doi:10.1136\/vr.164.21.647"},{"issue":"suppl 1","key":"ref2","series-title":"Vet Clin Pathol","first-page":"17","article-title":"Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas","volume":"48","author":"LeVine DN","year":"2019","unstructured":"LeVine DN, Brooks MB. Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas. Vet Clin Pathol. 2019;48(suppl 1):17-28. doi:10.1111\/vcp.12774"},{"issue":"3","key":"ref3","series-title":"J Vet Intern Med","first-page":"1041","article-title":"Development and implementation of a novel immune thrombocytopenia bleeding score for dogs","volume":"32","author":"Makielski KM","year":"2018","unstructured":"Makielski KM, Brooks MB, Wang C, Cullen JN, O\u2019Connor AM, LeVine DN. Development and implementation of a novel immune thrombocytopenia bleeding score for dogs. J Vet Intern Med. 2018;32(3):1041-1050. doi:10.1111\/jvim.15089"},{"issue":"5","key":"ref4","series-title":"Can Vet J","first-page":"514","article-title":"Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000-2013). R\u00e9sultat bas\u00e9 sur le protocole de traitement chez des patients atteints de thrombocytop\u00e9nie canine primaire \u00e0 m\u00e9diation immunitaire: 46 cas (2000-2013)","volume":"57","author":"Scuderi MA","year":"2016","unstructured":"Scuderi MA, Snead E, Mehain S, Waldner C, Epp T. Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000-2013). R\u00e9sultat bas\u00e9 sur le protocole de traitement chez des patients atteints de thrombocytop\u00e9nie canine primaire \u00e0 m\u00e9diation immunitaire: 46 cas (2000-2013). 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J Vet Intern Med. 2024;38(4):1958-1981. doi:10.1111\/jvim.16996"},{"issue":"4","key":"ref7","series-title":"J Vet Intern Med","first-page":"1982","article-title":"ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats","volume":"38","author":"LeVine DN","year":"2024","unstructured":"LeVine DN, Goggs R, Kohn B,  ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. J Vet Intern Med. 2024;38(4):1982-2007. doi:10.1111\/jvim.17079"},{"issue":"3","key":"ref8","series-title":"J Am Vet Med Assoc","first-page":"346","article-title":"Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia","volume":"238","author":"O\u2019Marra SK","year":"2011","unstructured":"O\u2019Marra SK, Delaforcade AM, Shaw SP. Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia. J Am Vet Med Assoc. 2011;238(3):346-352. doi:10.2460\/javma.238.3.346"},{"issue":"5","key":"ref9","series-title":"J Am Anim Hosp Assoc","first-page":"250","article-title":"Primary immune-mediated thrombocytopenia in 30 dogs (1997-2003)","volume":"44","author":"Putsche JC","year":"2008","unstructured":"Putsche JC, Kohn B. Primary immune-mediated thrombocytopenia in 30 dogs (1997-2003). J Am Anim Hosp Assoc. 2008;44(5):250-257. doi:10.5326\/0440250"},{"issue":"5","key":"ref10","series-title":"Vet Clin North Am Small Anim Pract","first-page":"1149","article-title":"Update on immununosuppressive therapies for dogs and cats","volume":"43","author":"Viviano KR","year":"2013","unstructured":"Viviano KR. Update on immununosuppressive therapies for dogs and cats. Vet Clin North Am Small Anim Pract. 2013;43(5):1149-1170. doi:10.1016\/j.cvsm.2013.04.009"},{"issue":"6","key":"ref11","series-title":"J Small Anim Pract","first-page":"330","article-title":"Treatment of five haemodynamically stable dogs with immune-mediated thrombocytopenia using mycophenolate mofetil as single agent","volume":"55","author":"Yau VK","year":"2014","unstructured":"Yau VK, Bianco D. Treatment of five haemodynamically stable dogs with immune-mediated thrombocytopenia using mycophenolate mofetil as single agent. J Small Anim Pract. 2014;55(6):330-333. doi:10.1111\/jsap.12203"},{"issue":"3","key":"ref12","series-title":"J Vet Intern Med","first-page":"536","article-title":"A prospective randomized clinical trial of vincristine versus human intravenous immunoglobulin for acute adjunctive management of presumptive primary immune-mediated thrombocytopenia in dogs","volume":"27","author":"Balog K","year":"2013","unstructured":"Balog K, Huang AA, Sum SO, Moore GE, Thompson C, Scott-Moncrieff JC. A prospective randomized clinical trial of vincristine versus human intravenous immunoglobulin for acute adjunctive management of presumptive primary immune-mediated thrombocytopenia in dogs. 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Treatment of severe immune-mediated thrombocytopenia with human IV immunoglobulin in 5 dogs. J Vet Intern Med. 2007;21(4):694-699."},{"issue":"1","key":"ref15","series-title":"BMC Vet Res","first-page":"96","article-title":"Treatment of 5 dogs with immune-mediated thrombocytopenia using romiplostim","volume":"12","author":"Kohn B","year":"2016","unstructured":"Kohn B, Bal G, Chirek A, Rehbein S, Salama A. Treatment of 5 dogs with immune-mediated thrombocytopenia using romiplostim. BMC Vet Res. 2016;12(1):96. 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Ann Blood. 2021;6:7. doi:10.21037\/aob-21-23"},{"key":"ref18","series-title":"Top Companion Anim Med","first-page":"100488","article-title":"Romiplostim as adjunctive treatment of refractory amegakaryocytic immune thrombocytopenia in a dog","volume":"42","author":"Polydoros T","year":"2021","unstructured":"Polydoros T, Ioannidi OM, Korsavvidis I, Stefanidis S, Antoniadis T, Mylonakis ME. Romiplostim as adjunctive treatment of refractory amegakaryocytic immune thrombocytopenia in a dog. Top Companion Anim Med. 2021;42:100488. doi:10.1016\/j.tcam.2020.100488"},{"issue":"4","key":"ref19","series-title":"Vet Rec Case Rep","first-page":"e174","article-title":"Use of eltrombopag and granulocyte colony-stimulating factor in treatment of lomustine overdose in a dog","volume":"9","author":"Aspinall S","year":"2021","unstructured":"Aspinall S, Desmas I, Bazelle J. Use of eltrombopag and granulocyte colony-stimulating factor in treatment of lomustine overdose in a dog. Vet Rec Case Rep. 2021;9(4):e174 doi:10.1002\/vrc2.174"},{"issue":"2","key":"ref20","series-title":"J Vet Intern Med","first-page":"890","article-title":"Eltrombopag treatment of a dog with idiopathic aplastic pancytopenia","volume":"34","author":"Kelly D","year":"2020","unstructured":"Kelly D, Lamb V, Juvet F. Eltrombopag treatment of a dog with idiopathic aplastic pancytopenia. J Vet Intern Med. 2020;34(2):890-892. doi:10.1111\/jvim.15738"},{"issue":"4","key":"ref21","series-title":"Vet Rec Case Rep","first-page":"e675","article-title":"Aplastic anaemia treated using eltrombopag in a dog","volume":"11","author":"Rodriguez-Cobos A","year":"2023","unstructured":"Rodriguez-Cobos A, Atencia S. Aplastic anaemia treated using eltrombopag in a dog. Vet Rec Case Rep. 2023;11(4):e675. doi:10.1002\/vrc2.675"},{"issue":"11","key":"ref22","series-title":"Drugs","first-page":"1285","article-title":"Thrombopoietin receptor agonists (TPO-RAs): drug class considerations for pharmacists","volume":"81","author":"Gilreath J","year":"2021","unstructured":"Gilreath J, Lo M, Bubalo J. Thrombopoietin receptor agonists (TPO-RAs): drug class considerations for pharmacists. Drugs. 2021;81(11):1285-1305. doi:10.1007\/s40265-021-01553-7"},{"issue":"suppl 1","key":"ref23","series-title":"Blood","first-page":"1223","article-title":"A phase 3 study of eltrombopag vs. standard first-line management for newly diagnosed immune thrombocytopenia in children: trial in progress update","volume":"142","author":"Grimes AB","year":"2023","unstructured":"Grimes AB, Grace RF, Rose MJ,  A phase 3 study of eltrombopag vs. standard first-line management for newly diagnosed immune thrombocytopenia in children: trial in progress update. 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PLoS ONE. 2018;13(6):e0198504. doi:10.1371\/journal.pone.0198504"},{"issue":"2","key":"ref26","series-title":"Vet Comp Oncol","first-page":"311","article-title":"Veterinary Cooperative Oncology Group\u2014Common Terminology Criteria for Adverse Events (VCOG-CTCAE v2) following investigational therapy in dogs and cats","volume":"19","author":"LeBlanc AK","year":"2021","unstructured":"LeBlanc AK, Atherton M, Bentley RT,  Veterinary Cooperative Oncology Group\u2014Common Terminology Criteria for Adverse Events (VCOG-CTCAE v2) following investigational therapy in dogs and cats. Vet Comp Oncol. 2021;19(2):311-352. doi:10.1111\/vco.12677"},{"issue":"3","key":"ref27","series-title":"Ther Adv Hematol","first-page":"155","article-title":"Eltrombopag, a thrombopoietin-receptor agonist in the treatment of adult chronic immune thrombocytopenia: a review of the efficacy and safety profile","volume":"3","author":"Cheng G","year":"2012","unstructured":"Cheng G. Eltrombopag, a thrombopoietin-receptor agonist in the treatment of adult chronic immune thrombocytopenia: a review of the efficacy and safety profile. Ther Adv Hematol. 2012;3(3):155-164. doi:10.1177\/2040620712442525"},{"key":"ref28","series-title":"Clin Appl Thromb Hemost","first-page":"10760296211005555","article-title":"Eltrombopag effectiveness and tolerability in chronic immune thrombocytopenia: a meta-analysis","volume":"27","author":"Ahmed HAW","year":"2021","unstructured":"Ahmed HAW, Masoud AT, Han J,  Eltrombopag effectiveness and tolerability in chronic immune thrombocytopenia: a meta-analysis. 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Neutropenia in dogs receiving vincristine for treatment of presumptive immune-mediated thrombocytopenia. J Vet Intern Med. 2021;35(1):226-233. doi:10.1111\/jvim.16029"},{"issue":"1","key":"ref31","series-title":"Exp Hematol","first-page":"85","article-title":"Discovery and characterization of a selective, nonpeptidyl thrombopoietin receptor agonist","volume":"33","author":"Erickson-Miller CL","year":"2005","unstructured":"Erickson-Miller CL, DeLorme E, Tian SS,  Discovery and characterization of a selective, nonpeptidyl thrombopoietin receptor agonist. Exp Hematol. 2005;33(1):85-93. doi:10.1016\/j.exphem.2004.09.006"},{"issue":"4","key":"ref32","series-title":"Biophys Rev","first-page":"559","article-title":"Protein-protein interaction modulators: advances, successes and remaining challenges","volume":"11","author":"Mabonga L","year":"2019","unstructured":"Mabonga L, Kappo AP. Protein-protein interaction modulators: advances, successes and remaining challenges. 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Vet Rec. 2009;23:164(21):647-651. doi:10.1136\/vr.164.21.647"},{"issue":"suppl 1","key":"ref2","series-title":"Vet Clin Pathol","first-page":"17","article-title":"Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas","volume":"48","author":"LeVine DN","year":"2019","unstructured":"LeVine DN, Brooks MB. Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas. Vet Clin Pathol. 2019;48(suppl 1):17-28. doi:10.1111\/vcp.12774"},{"issue":"3","key":"ref3","series-title":"J Vet Intern Med","first-page":"1041","article-title":"Development and implementation of a novel immune thrombocytopenia bleeding score for dogs","volume":"32","author":"Makielski KM","year":"2018","unstructured":"Makielski KM, Brooks MB, Wang C, Cullen JN, O\u2019Connor AM, LeVine DN. Development and implementation of a novel immune thrombocytopenia bleeding score for dogs. J Vet Intern Med. 2018;32(3):1041-1050. doi:10.1111\/jvim.15089"},{"issue":"5","key":"ref4","series-title":"Can Vet J","first-page":"514","article-title":"Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000-2013). R\u00e9sultat bas\u00e9 sur le protocole de traitement chez des patients atteints de thrombocytop\u00e9nie canine primaire \u00e0 m\u00e9diation immunitaire: 46 cas (2000-2013)","volume":"57","author":"Scuderi MA","year":"2016","unstructured":"Scuderi MA, Snead E, Mehain S, Waldner C, Epp T. Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000-2013). R\u00e9sultat bas\u00e9 sur le protocole de traitement chez des patients atteints de thrombocytop\u00e9nie canine primaire \u00e0 m\u00e9diation immunitaire: 46 cas (2000-2013). Can Vet J. 2016;57(5):514-518."},{"issue":"2","key":"ref5","series-title":"J Vet Intern Med","first-page":"1022","article-title":"A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs","volume":"38","author":"Brooks MB","year":"2024","unstructured":"Brooks MB, Goggs R, Frye AH,  A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs. J Vet Intern Med. 2024;38(2):1022-1034. doi:10.1111\/jvim.16985"},{"issue":"4","key":"ref6","series-title":"J Vet Intern Med","first-page":"1958","article-title":"ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats","volume":"38","author":"LeVine DN","year":"2024","unstructured":"LeVine DN, Kidd L, Garden OA,  ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats. J Vet Intern Med. 2024;38(4):1958-1981. doi:10.1111\/jvim.16996"},{"issue":"4","key":"ref7","series-title":"J Vet Intern Med","first-page":"1982","article-title":"ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats","volume":"38","author":"LeVine DN","year":"2024","unstructured":"LeVine DN, Goggs R, Kohn B,  ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. J Vet Intern Med. 2024;38(4):1982-2007. doi:10.1111\/jvim.17079"},{"issue":"3","key":"ref8","series-title":"J Am Vet Med Assoc","first-page":"346","article-title":"Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia","volume":"238","author":"O\u2019Marra SK","year":"2011","unstructured":"O\u2019Marra SK, Delaforcade AM, Shaw SP. Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia. J Am Vet Med Assoc. 2011;238(3):346-352. doi:10.2460\/javma.238.3.346"},{"issue":"5","key":"ref9","series-title":"J Am Anim Hosp Assoc","first-page":"250","article-title":"Primary immune-mediated thrombocytopenia in 30 dogs (1997-2003)","volume":"44","author":"Putsche JC","year":"2008","unstructured":"Putsche JC, Kohn B. Primary immune-mediated thrombocytopenia in 30 dogs (1997-2003). J Am Anim Hosp Assoc. 2008;44(5):250-257. doi:10.5326\/0440250"},{"issue":"5","key":"ref10","series-title":"Vet Clin North Am Small Anim Pract","first-page":"1149","article-title":"Update on immununosuppressive therapies for dogs and cats","volume":"43","author":"Viviano KR","year":"2013","unstructured":"Viviano KR. Update on immununosuppressive therapies for dogs and cats. Vet Clin North Am Small Anim Pract. 2013;43(5):1149-1170. doi:10.1016\/j.cvsm.2013.04.009"},{"issue":"6","key":"ref11","series-title":"J Small Anim Pract","first-page":"330","article-title":"Treatment of five haemodynamically stable dogs with immune-mediated thrombocytopenia using mycophenolate mofetil as single agent","volume":"55","author":"Yau VK","year":"2014","unstructured":"Yau VK, Bianco D. Treatment of five haemodynamically stable dogs with immune-mediated thrombocytopenia using mycophenolate mofetil as single agent. 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