• Marco Biolato, Federica Vitale, Giuseppe Marrone, Luca Miele, and Antonio Grieco.
• Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.
• Medicine (Baltimore). 2022 Nov 4; 101 (44): e31429e31429.

RationaleLusutrombopag is a thrombopoietin receptor agonist which reduces the need for platelet transfusions before planned invasive procedures. A post hoc analysis of data from the registration trials observed that lusutrombopag-treated patients who achieved a platelet count > 50 × 109/L (responder patients) did so in a median of 6 days and the effect on platelet count lasted for nearly 3 weeks in total. Since patients with cirrhosis often require repeat invasive procedures, this kind of response-time trend sheds light on the possibility of placing more than one invasive procedure within a single course of lusutrombopag treatment.Patient ConcernsPlatelet transfusion represents the gold standard in this setting, but is limited by the risk of adverse events and limited availability.DiagnosesWe describe our experience with lusutrombopag in three patients with severe cirrhosis-associated thrombocytopenia who underwent multiple invasive procedures after a single course of treatment.InterventionsThe treatment schedule is lusutrombopag orally 3 mg/daily for 7 days and then a time window of 6 days (day 9-14) for the elective invasive procedure.OutcomesAll three patients achieved good response to lusutrombopag treatment and were able to undergone more invasive procedures in the same course of treatment without need of platelet transfusion.Lessonsour preliminary experience supports the safety and the effectiveness of lusutrombopag in patients with severe cirrhosis-associated thrombocytopenia who underwent multiple invasive elective procedures after a single course.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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