From the Guidelines
A slightly low platelet count of 136 in a patient taking Taltz (ixekizumab) with otherwise normal blood work results, including a WBC of 5, hemoglobin of 16.6, and hematocrit of 49.6, is not typically a cause for immediate concern and does not necessitate discontinuation of the medication. The patient's platelet count is still within a relatively safe range, and according to the guidelines from the study published in the Annals of Internal Medicine 1, prophylactic platelet transfusion is not usually recommended for patients with platelet counts above 50 × 10^9 cells/L, which is well below the patient's current count.
- Key points to discuss with the patient include:
- The importance of regular blood monitoring to track platelet levels, ideally every 3-6 months.
- Awareness of symptoms that could indicate a more significant issue, such as unusual bruising, petechiae, prolonged bleeding, or blood in urine or stool.
- The mechanism behind Taltz-associated thrombocytopenia and its potential impact on platelet production or survival.
- The need for open communication with their healthcare provider about any new symptoms or concerns. Given the patient's current platelet count and the absence of any severe bleeding complications reported in the literature for counts above 50 × 10^9 cells/L 1, continuation of the prescribed Taltz regimen under regular monitoring is a reasonable approach, prioritizing the management of the underlying condition for which Taltz is prescribed while keeping a watchful eye on the platelet count.
From the FDA Drug Label
Thrombocytopenia Ninety eight percent of cases of thrombocytopenia were Grade 1 (3% for TALTZ 80 mg Q2W versus 1% for placebo; ≥75,000 cells/mm3 to <150,000 cells/mm3). Thrombocytopenia in subjects treated with TALTZ was not associated with an increased rate of bleeding compared to subjects treated with placebo You can tell the patient that their platelet count is slightly low but it's not associated with an increased risk of bleeding, and we will continue to monitor their blood work results 2. The patient's other blood work results, including WBC, hemoglobin, and hematocrit, are within normal limits, so we will proceed with their current treatment plan and continue to monitor their condition closely 2.
From the Research
Blood Work Results Explanation
- The patient's blood work results show a white blood cell (WBC) count of 5, which is within the normal range, hemoglobin level of 16.6, hematocrit of 49.6, and a platelet count of 136, which is slightly low 3.
- The patient is taking Taltz (ixekizumab), and it is essential to consider the potential effects of this medication on blood work results, although there is no direct evidence in the provided studies linking Taltz to significant changes in blood cell counts.
Implications of Slightly Low Platelet Count
- A slightly low platelet count may not be a cause for concern, but it is crucial to monitor the patient's condition and perform follow-up blood tests to ensure the platelet count returns to normal range 4, 5.
- The combination of WBC and platelet count can be a better predictor of certain health outcomes, such as in-hospital mortality and pneumonia, than either parameter alone 5, 6.
Patient Communication
- You can tell the patient: "Your blood work results show a normal white blood cell count, hemoglobin level, and hematocrit, but your platelet count is slightly low. We will continue to monitor your condition and perform follow-up blood tests to ensure your platelet count returns to normal."
- Additionally, you can say: "It is essential to continue taking your medication, Taltz, as prescribed and to follow up with your healthcare provider to discuss any concerns or questions you may have about your blood work results."