INDICATIONS

Nplate® is a thrombopoietin receptor agonist indicated for the treatment of thrombocytopenia in adult patients with immune thrombocytopenia (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. Nplate® is indicated for the treatment of thrombocytopenia in pediatric patients 1 year of age and older with ITP for at least 6 months who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.


Nplate® is not indicated for the treatment of thrombocytopenia due to myelodysplastic syndrome (MDS) or any cause of thrombocytopenia other than ITP. Nplate® should be used only in patients with ITP whose degree of thrombocytopenia and clinical condition increase the risk for bleeding. Nplate® should not be used in an attempt to normalize platelet counts.

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PRESCRIBING INFORMATION INDICATIONS IMPORTANT SAFETY INFORMATION VISIT PATIENT SITE
Nplate® campaign-Reasons to choose Nplate® first at second-line for patients at any stage of their ITP journey
Nplate® campaign-Reasons to choose Nplate® first at second-line for patients at any stage of their ITP journey

Don't Wait. Treat Now With Nplate®

Rapid Efficacy That Lasts, No Known Drug Interactions OR Food Restrictions, Opportunity for Treatment-Free Remission2-4

Over 483,000 patients served globally with Nplate®.5
Choose Nplate® first at second-line—Learn Why
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Learn about once-weekly dosing
Treatment-free remission
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CLINICAL STUDIES DEMONSTRATED:

Rapid Efficacy That Lasts2,3

Nplate® is the only approved immune thrombocytopenia (ITP) therapy with treatment-free remission in the label2,3

93% of patients achieved any platelet response
93% of patients achieved any platelet response*
(n = 70/75)2
Approximately one-third of ITP patients achieved treatment-free remission
~ 1/3 of patients achieved treatment-free remission
(n = 24/75)2,3
Responses seen as early as seven days with median of 2.1 weeks
Responses seen as early
as 7 days with a median of 2.1 weeks2,6,†​
  • ASH ITP guidelines suggest Nplate® as a second-line therapy over non–TPO-RAs like rituximab and limiting duration of steroids to ≤ 6 weeks7,‡

Lasting stability: 61% of patients achieved a response for ≥ 11 months (n = 46/75)3

*Platelet response was defined as a platelet count ≥ 50 x 109/L during 12-month treatment period.2

†95% CI: 1.1, 3.0; 5.56%, 47.22%, and 61.11% of patients responded by weeks 1, 2, and 3, respectively. 2,6

‡Rituximab is not FDA-approved for use in ITP. 8

  • Study Design
    Nplate® was studied in a 52-week, open-label, single-arm, phase 2 trial of 75 adults with ITP for ≤ 6 months who had an insufficient response (platelet count ≤ 30 x 109/L) to first-line ITP treatment, including corticosteroids. Treatment-free remission was a secondary endpoint defined as maintaining every platelet count at ≥ 50 x 109/L for at least 6 months in the absence of any ITP treatment and occurred in 32% (n = 24/75) of patients.1,2 The primary endpoint of the study (N = 75) was the cumulative number of months in which patients achieved a platelet response.2,3,6,9

Choose Nplate® first when your ITP patient needs second-line treatment.3
See the study data on rapid and lasting efficacy

Established Safety Profile Without Food Restrictions

Nplate® is the once-weekly, in-office, subcutaneous injection that offers:

5 years
No new safety signals observed up to 5 years of continuous treatment10,*
No daily pill reminders
No need to remember to take a pill every day2,11-13
No liver monitoring required
No liver monitoring, and no known drug interactions or dietary restrictions2,4
See established safety profile of Nplate®

*Long-term safety data: Based on an open-label, single-arm, extension study of 291 adults with chronic ITP who had at least one dose of Nplate®. Subjects could enter any time during the 277-week period. Mean treatment duration was 110 weeks. Study results: AEs did not increase in frequency or type with longer Nplate® drug exposure. Primary assessment/incidence: Serious treatment-related AEs, 8% (24/291); thrombotic events, 6.5% (19/291); bone marrow reticulin increase, 1.4% (4/291); neutralizing antibody formation, < 1% (2/291); and deaths, 5% (16/291).2,10

AFTER THE CLINICAL DECISION HAS BEEN MADE, CONSIDER THAT:

Nplate® Has the Highest Percentage of Patient Claims With $0 OOP Costs vs Oral Agents* and Broad Coverage14,15

$0 OOP costs for Nplate®14

74%of patient claims*

$0 OOP costs for
oral ITP medications14

54%of patient claims*

Nplate® also offers broad coverage (86%).15
See cost and coverage information

*Analysis from 2020 to 2021 for Commercial and Medicare patient claims combined. Data based on IQVIA LAAD claims data. Oral OOP percent is a weighted average of claims for eltrombopag, avatrombopag, and fostamatinib disodium hexahydrate.14

2L, second line; AE, adverse event; ASH, American Society of Hematology; CI, confidence interval; OOP, out-of-pocket; TPO-RA, thrombopoietin receptor agonist.

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483,000+ Served Worldwide5

Important Safety Information

Risk of Progression of Myelodysplastic Syndromes to Acute Myelogenous Leukemia

  • In Nplate® (romiplostim) clinical trials of patients with myelodysplastic syndromes (MDS) and severe thrombocytopenia, progression from MDS to acute myelogenous leukemia (AML) has been observed.
  • Nplate® is not indicated for the treatment of thrombocytopenia due to MDS or any cause of thrombocytopenia other than ITP.

Thrombotic/Thromboembolic Complications

  • Thrombotic/thromboembolic complications may result from increases in platelet counts with Nplate® use. Portal vein thrombosis has been reported in patients with chronic liver disease receiving Nplate®.
  • To minimize the risk for thrombotic/thromboembolic complications, do not use Nplate® in an attempt to normalize platelet counts. Follow the dose adjustment guidelines to achieve and maintain a platelet count of ≥ 50 x 109/L.

Loss of Response to Nplate®

  • Hyporesponsiveness or failure to maintain a platelet response with Nplate® should prompt a search for causative factors, including neutralizing antibodies to Nplate®.
  • To detect antibody formation, submit blood samples to Amgen (1‑800‑772‑64361‑800‑772‑6436). Amgen will assay these samples for antibodies to Nplate® and thrombopoietin (TPO).
  • Discontinue Nplate® if the platelet count does not increase to a level sufficient to avoid clinically important bleeding after 4 weeks at the highest weekly dose of 10 mcg/kg.
Adverse Reactions
Adult ITP
  • In the placebo-controlled trials of adult ITP patients, headache was the most commonly reported adverse drug reaction, occurring in 35% of patients receiving Nplate® and 32% of patients receiving placebo. Adverse drug reactions in adults with a ≥ 5% higher patient incidence in Nplate® versus placebo were Arthralgia (26%, 20%), Dizziness (17%, 0%), Insomnia (16%, 7%), Myalgia (14%, 2%), Pain in Extremity (13%, 5%), Abdominal Pain (11%, 0%), Shoulder Pain (8%, 0%), Dyspepsia (7%, 0%), and Paresthesia (6%, 0%).
  • The safety profile of Nplate® was similar across patients, regardless of ITP duration. The following adverse reactions (at least 5% incidence and at least 5% more frequent with Nplate® compared with placebo or standard of care) occurred in Nplate® patients with ITP duration up to 12 months: bronchitis, sinusitis, vomiting, arthralgia, myalgia, headache, dizziness, diarrhea, upper respiratory tract infection, cough, nausea and oropharyngeal pain. The adverse reaction of thrombocytosis occurred with an incidence of 2% in adults with ITP duration up to 12 months.
Pediatric ITP
  • The most common adverse reactions experienced by ≥ 5% of patients receiving Nplate® with ≥ 5% higher incidence in the Nplate® arm across the two placebo-controlled trials were contusion (41%), upper respiratory tract infection (31%), oropharyngeal pain (25%), pyrexia (24%), diarrhea (20%), rash (15%), and upper abdominal pain (14%).
  • In pediatric patients of age ≥ 1 year receiving Nplate® for ITP, adverse reactions with an incidence of ≥ 25% in the two randomized trials were: contusion (41%), upper respiratory tract infection (31%), and oropharyngeal pain (25%).
  • In a long-term, single arm, open label pediatric safety study, headache occurred in 78/203 patients (38%); the incidence rates of other adverse reactions were similar to those reported in the placebo-controlled studies.

Nplate® administration may increase the risk for development or progression of reticulin fiber formation within the bone marrow. This formation may improve upon discontinuation of Nplate®. In a clinical trial, one patient with ITP and hemolytic anemia developed marrow fibrosis with collagen during Nplate® therapy.

INDICATIONS

Nplate® is a thrombopoietin receptor agonist indicated for the treatment of thrombocytopenia in adult patients with immune thrombocytopenia (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. Nplate® is indicated for the treatment of thrombocytopenia in pediatric patients 1 year of age and older with ITP for at least 6 months who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy.

Nplate® is not indicated for the treatment of thrombocytopenia due to myelodysplastic syndrome (MDS) or any cause of thrombocytopenia other than ITP. Nplate® should be used only in patients with ITP whose degree of thrombocytopenia and clinical condition increase the risk for bleeding. Nplate® should not be used in an attempt to normalize platelet counts.

Please see full Prescribing Information and Medication Guide.

Important Safety Information

Risk of
Progression of Myelodysplastic Syndromes to Acute Myelogenous Leukemia

  • In Nplate® (romiplostim) clinical trials of patients with myelodysplastic syndromes (MDS) and severe thrombocytopenia, progression from MDS to acute myelogenous leukemia (AML) has been observed.
  • Nplate® is not indicated for the treatment of thrombocytopenia due to MDS or any cause of thrombocytopenia other than ITP.

Thrombotic/Thromboembolic Complications

  • Thrombotic/thromboembolic complications may result from increases in platelet counts with Nplate® use. Portal vein thrombosis has been reported in patients with chronic liver disease receiving Nplate®.
  • To minimize the risk for thrombotic/thromboembolic complications, do not use Nplate® in an attempt to normalize platelet counts. Follow the dose adjustment guidelines to achieve and maintain a platelet count of ≥ 50 x 109/L.

Loss of Response to Nplate®

References: 1. Lozano ML, Mingot-Castellano ME, Perera MM, et al. Deciphering predictive factors for choice of thrombopoietin receptor agonist, treatment free responses, and thrombotic events in immune thrombocytopenia. Sci Rep. 2019;9(1):16680. 2. Nplate® (romiplostim) prescribing information, Amgen. 3. Newland A, Godeau B, Priego V, et al. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol. 2016;172(2):262-273. 4. Data on file, Amgen; Clinical Study Report 20080435; 2014. 5. Data on file, Amgen; Number of patients treated with Nplate® from launch through to June 2023 Updated; 2023. 6. Data on file, Amgen; Time to Onset, biostatistical analysis; 2019. 7. Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829-3866. 8. Rituxan® (rituximab) full Prescribing Information, Genentech. 9. Newland A, Godeau B, Priego V, et al. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol. 2016;172(Suppl):1-4. 10. Kuter DJ, Bussel JB, Newland A, et al. Long-term treatment with romiplostim in patients with chronic immune thrombocytopenia: safety and efficacy. Br J Haematol. 2013;161(3):411-423. 11. Promacta® (eltrombopag) full Prescribing Information, Novartis. 12. Doptelet® (avatrombopag) full Prescribing Information, Sobi. 13. Tavalisse® (fostamatinib disodium hexahydrate) full Prescribing Information, Rigel. 14. Data on file, Amgen; Nplate® IQVIA LAAD 2020 and 2021 OOP Cost Analysis Medicare Commercial Combined ALL; 2022. 15. Data on file, Amgen; Nplate® - coverage from MMIT; 2022.