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This is a combination therapy consisting of lusutrombopag, an orally bioavailable small molecule agonist of the thrombopoietin receptor, and recombinant human thrombopoietin (rhTPO), a biologic form of the endogenous cytokine. Lusutrombopag stimulates platelet production by binding to and activating the transmembrane domain of the TPO receptor on megakaryocytes, promoting their proliferation and differentiation from hematopoietic stem cells. Recombinant human thrombopoietin mimics natural TPO to further stimulate megakaryocyte maturation and platelet production. This combination is being investigated for its efficacy in treating thrombocytopenia in patients with chronic liver disease who are scheduled for elective invasive surgery[1][4][9]. The rationale is that dual stimulation may provide additive or synergistic effects on increasing platelet counts.
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