{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:23:55Z","timestamp":1788315835414,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grifols"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/objectives: Fostamatinib is a spleen tyrosine kinase (SYK) inhibitor approved for the treatment of adult patients with chronic immune thrombocytopenia (ITP). There is little information about dose tapering and sustained remission after discontinuation in ITP. In this retrospective multicenter study, we evaluated efficacy and safety of fostamatinib in adult patients with ITP before, during, and after tapering\/discontinuation (T\/D). Methods: T\/D was performed on subjects who achieved complete platelet response (CR) with progressive, conditional dose reduction every four weeks. Results: Sixty-one patients were included from 14 reference centers between October 2021 and May 2023. In subjects that completed T\/D (n = 9), the median time from treatment initiation to response was 21 days (IQR: 7.5\u201342), median time from treatment initiation to CR was 28 days (IQR: 28\u201342), median time from treatment initiation to the start of tapering was 116 days (IQR: 42\u2013140), and duration of tapering was 112.5 days (IQR: 94.5\u2013191). The median platelet count was 232 \u00d7 109\/L (IQR: 152\u2013345 \u00d7 109\/L) at tapering and 190 \u00d7 109\/L (IQR: 142.5\u2013316.5 \u00d7 109\/L) at discontinuation. With a median follow-up since discontinuation of 263 days (IQR: 247\u2013313 days), only two patients have relapsed (at 63 and 73 days). Fostamatinib was restarted, achieving a new CR. Platelet counts higher than 100 \u00d7 109\/L in week 12 were the only positive predictive factors for successful tapering and discontinuation. Conclusions: Sustained response in patient with ITP treated with fostamatinib could be developed. The prognostic factors and recommended scheme of tapering still have to be evaluated.<\/jats:p>","DOI":"10.3390\/jcm13216294","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T04:10:14Z","timestamp":1729570214000},"page":"6294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Platelet Responses After Tapering and Discontinuation of Fostamatinib in Patients with Immune Thrombocytopenia: A Continuation of the Fostasur Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Mar\u00eda Eva","family":"Mingot-Castellano","sequence":"first","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS\/CSIC), Universidad de Sevilla, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Garc\u00eda-Donas","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar\u00eda","family":"Campos-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Jerez de la Frontera, 11405 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Carmen Fern\u00e1ndez-S\u00e1nchez","family":"de Mora","sequence":"additional","affiliation":[{"name":"Hospital Universitario Reina Sof\u00eda, 14004 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefa","family":"Luis-Navarro","sequence":"additional","affiliation":[{"name":"Hospital de Riotinto, 21660 Huelva, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Francisco","family":"Dom\u00ednguez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez, 21005 Huelva, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"del Mar Nieto-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Complejo Hospitalario de Ja\u00e9n, 23006 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"S\u00e1nchez-Baz\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Yera-Cobo","sequence":"additional","affiliation":[{"name":"Hospital Puerta del Mar, 11009 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Cardesa-Cabrera","sequence":"additional","affiliation":[{"name":"Hospital de la Merced de Osuna, 41640 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Jim\u00e9nez-Gonzalo","sequence":"additional","affiliation":[{"name":"Hospital de la Merced de Osuna, 41640 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Caparr\u00f3s-Miranda","sequence":"additional","affiliation":[{"name":"Hospital Virgen de la Victoria, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Entrena-Ure\u00f1a","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Jurado","family":"Herrera","sequence":"additional","affiliation":[{"name":"Hospital Torrec\u00e1rdenas, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Fern\u00e1ndez Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hospital Universitario San Cecilio, 18007 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"D\u00edaz-Canales","sequence":"additional","affiliation":[{"name":"Hospital de la Serran\u00eda de Ronda, 29400 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Moreno-Carrasco","sequence":"additional","affiliation":[{"name":"Hospital de la Serran\u00eda de Ronda, 29400 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Calder\u00f3n-Cabrera","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS\/CSIC), Universidad de Sevilla, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramiro Jos\u00e9","family":"N\u00fa\u00f1ez-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS\/CSIC), Universidad de Sevilla, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Pedrote-Amador","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo, Instituto de Biomedicina de Sevilla (IBIS\/CSIC), Universidad de Sevilla, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyes","family":"Jim\u00e9nez B\u00e1rcenas","sequence":"additional","affiliation":[{"name":"Hospital de la Serran\u00eda de Ronda, 29400 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1182\/blood-2008-07-162503","article-title":"Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: Report from an international working 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