L-methionyl[human immunogloblin heavy constant gamma 1-(227 C-terminal residues)-peptide (Fc fragment)] fusion protein with 41 amino acids peptide, (7-7′:10,10′)-bisdisulfide dimer
CAS Number
267639-76-9N
IUPHAR/BPS
6974
ChemSpider
none
UNII
GN5XU2DXKV
ChEMBL
CHEMBL1201832N
Chemical and physical data
Formula
C2634H4086N722O790S18
Molar mass
59 kg/mol
NY (what is this?)(verify)
Romiplostim (rINN, USAN) is a fusion protein analog of thrombopoietin, a hormone that regulates platelet production.
Contents
1Indications and Marketing
2Treatment regimen
3Clinical efficacy
4Side-effects
5External links
6References
Indications and Marketing[edit]
The drug was developed by Amgen and is marketed under the trade name Nplate through a restricted usage program called NEXUS.[1] During development and clinical trials the drug was called AMG531.
Romiplostim is indicated as a potential treatment for chronic idiopathic (immune) thrombocytopenic purpura (ITP).[2] Romiplostim was designated an orphan drug by the U.S. Food and Drug Administration (FDA) in 2003, as the chronic ITP population in the USA is under 200,000 (the chronic adult ITP population in the USA is thought to be around 60,000, with women outnumbering men by a factor of two).[3] The wholesale cost of romiplostim if administered weekly is currently estimated at US $55,250 per year.[4]
On August 22, 2008, the FDA approved romiplostim as a long-term treatment for chronic ITP in adults who have not responded to other treatments, such as corticosteroids, intravenous immunoglobulin, Rho(D) immune globulin or splenectomy.[1][5]
Treatment regimen[edit]
Romiplostim treatment is generally administered at weekly intervals via subcutaneous injection. Prior to injection, a complete blood count (CBC) is obtained, as the dosage is dependent on the individual's body weight and platelet count at the time of treatment. The goal of treatment is to maintain the count above 50,000 per cubic millimeter (mm3) of blood, not to achieve a normal count—defined as 150,000–450,000 per mm3 in most healthy individuals. If a count of 200,000 or higher is achieved for two consecutive weeks a reduced dose is administered or treatment is suspended until the count decreases below 200,000. Discontinuation of romiplostim must be approached with great caution, as a rapid decrease in the platelet count may occur, possibly leading to bleeding diathesis.
Clinical efficacy[edit]
In well designed, 24-week, Phase III trials, romiplostim was significantly more effective than placebo in achieving the primary endpoint of a protocol-defined durable platelet response in nonsplenectomized or splenectomized adults with chronic immune thrombocytopenic purpura.[6]
Side-effects[edit]
Romiplostim's effect is to stimulate the patient's megakaryocytes to produce platelets at a more rapid than normal rate, thus overwhelming the immune system's ability to destroy them. As doing so involves changes to the bone marrow chemistry, a number of potentially serious side-effects may develop, including death, myalgia, joint and extremity discomfort, insomnia, thrombocytosis, which may lead to potentially fatal clots, and bone marrow fibrosis, the latter which may result in an unsafe decrease in the red blood count.
^Kuter DJ, Bussel JB, Lyons RM, et al. (February 2008). "Efficacy of romiplostim in patients with chronic immune thrombocytopenic purpura: a double-blind randomised controlled trial". Lancet. 371 (9610): 395–403. doi:10.1016/S0140-6736(08)60203-2. PMID 18242413.
^"Amgen to Discuss Romiplostim BLA". drugs.com. March 12, 2008. Retrieved 2008-11-04.
^Perreault, S; Burzynski, J. "Romiplostim: a novel thrombopoiesis-stimulating agent". Am J Health Syst Pharm. 66: 817–24. doi:10.2146/ajhp080524. PMID 19386944.
^"FDA Approves Nplate(TM) for Long-Term Treatment of Adult Chronic ITP" (Press release). Amgen. August 22, 2008. Retrieved 2008-09-04.
^Frampton J. E., Lyseng-Williamson K. A. (2009). "Romiplostim". Drugs. 69 (3): 307–317. doi:10.2165/00003495-200969030-00006. PMID 19275274.
v
t
e
Antihemorrhagics (B02)
Antihemorrhagics (coagulation)
Systemic
Vitamin K
Phytomenadione (K1)
Menadione (K3)
Coagulation factors
intrinsic: IX/Nonacog alfa
VIII/Moroctocog alfa/Turoctocog alfa
extrinsic: VII/Eptacog alfa
common: X
II/Thrombin
I/Fibrinogen
XIII/Catridecacog
combinations: Prothrombin complex concentrate (II, VII, IX, X, protein C and S)
The Dalles, Oregon From Wikipedia, the free encyclopedia Jump to navigation Jump to search This article is about the city in Oregon. For the nearby geological formation, see Celilo Falls. For other uses, see Dalles. Not to be confused with the town of Dallas, Oregon. City in Wasco County The Dalles City The Dalles and the Columbia River in November 2008 Flag Seal Motto(s): "Cognito timor Vincit" (Latin), "Knowledge Conquers Fear" (English) Location in Oregon Coordinates: 45°36′4″N 121°10′58″W / 45.60111°N 121.18278°W / 45.60111; -121.18278 Coordinates: 45°36′4″N 121°10′58″W / 45.60111°N 121.18278°W / 45.60111; -121.18278 County Wasco County Incorporated 1857 Government • Mayor Stephen Elliott Lawrence (D) [1] [2] Area [3] • Total 6.61 sq mi (17.12 km 2 ) • Land 6.35 sq mi (16.45 km 2 ) • Water 0.26 sq mi (0.67 km 2 ) Elevation 109 ft (33 m) Population (2010) [4] • Total 13,620 • Estimate (2013) [5]
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Museum on the Mound From Wikipedia, the free encyclopedia Jump to navigation Jump to search Numismatics museum in The Mound, Edinburgh Museum on the Mound The Museum is located in the Bank of Scotland head office, Edinburgh Location of the Museum in Edinburgh Location The Mound, Edinburgh Coordinates 55°57′01″N 3°11′36″W / 55.95028°N 3.19333°W / 55.95028; -3.19333 Coordinates: 55°57′01″N 3°11′36″W / 55.95028°N 3.19333°W / 55.95028; -3.19333 Type Numismatics museum Collections Banknotes of Scotland, Scottish coinage, economics Visitors 50,000 Owner Bank of Scotland Public transit access Princes Street Edinburgh Waverley Website museumonthemound.com The Museum on the Mound is a museum in Edinburgh, Scotland, that focuses on money, coinage and economics. It is located in the Bank of Scotland Head Office building (latterly part of HBOS and now part of Lloyds Banking Group) on The Mound. It has more than 50,000 visitors per yea