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Table 2 Comparison of high-dose intravenous immunoglobulin (IVIG) therapy and thrombopoietin receptor agonist (TPO-RA)

From: Successful resection of intrahepatic cholangiocarcinoma with idiopathic thrombocytopenic purpura using thrombopoietin receptor agonist: a case report

Characteristic

IVIG therapy

TPO-RA

Time of the beginning of the increase

3–4 days

5–7 days

Time before reaching the maximum

7 days

12–16 days

Effective rate

70–90%

80%

Validity

2–4 weeks

2 weeks

Rate of platelet transfusion avoidance

(−)

72%

Adverse events

Headache, fever, nausea

Cytopenia

Muscle pain, general malaise

Arterial and venous thrombosis

Aseptic meningitis

Bone marrow reticulin fibrosis

Acute renal failure

Rebound thrombocytopenia after discontinuation (platelet decrease relative to baseline)

Infection (HCV, HIV, etc.)

Increases of ALT concentration

Thrombosis

Headache

Cerebral infarction

 

Pulmonary infarction

 

Cost

Venoglobulin IH® 5% IV

REVOLADE® Tablets 12.5 mg 22.61 USD/tablet

5 g/100 mL = 349.62 USD/vial

REVOLADE® Tablets 25 mg 44.55 USD/tablet

In case, 400 mg/kg/day, 50 kg

In our case, preoperative for 23 days, 25 mg/day

349.62 × 4 vial × 5 days

+ postoperative 30 days

= 6992.35 USD

= 2396.96 USD

  1. ALT alanine aminotransferase, IV intravenous, HCV hepatitis C virus, HIV human immunodeficiency virus, USD United States dollars