Eltrombopag Diolamine

Novartis has been steadily dialing back its U.S. workforce in recent years. Novartis is making further workforce reductions at its U.S. headquarters in New Jersey, planning to eliminate 114 positions as the drugmaker rejigs its sales team for rare-disease medicines.The Swiss pharma telegraphed the layoffs in a recent Worker Adjustment and Retraining Notification (WARN) filing (PDF) to the state, with the cuts slated to take effect from late June to November. “[O]ur US Customer Engagement organization has been evaluating opportunities to evolve our field sales team structures to better support the unique needs of patients and customers in the rare and ultra-rare disease spaces—where Novartis has a strong footprint and focus with in-market products and upcoming pivotal launches,” a Novartis spokesperson told Fierce Pharma. “To that end, we are making some organizational changes that result in some roles being eliminated, modified, and created.”  The adjustment marks the latest in a series of layoffs at Novartis, which can be traced all the way back to a major reorganization launched in 2022. Novartis offers several drugs in the rare disease space. These include chronic myeloid leukemia therapy Tasigna and Promacta for treating low blood platelet counts in certain patients, including those with the rare blood disorders chronic immune thrombocytopenia (ITP) and aplastic anemia. The two meds, together with the megablockbuster heart failure treatment Entresto, form the largest single-year patent cliff in Novartis’ history, presenting a notable challenge for the company in 2026.Novartis is also managing a few new rare disease launches in the autoimmune field, including Rhapsido for chronic spontaneous urticaria (CSU). It’s additionally rolling out two rare kidney disease therapies, Vanrafia and Fabhalta, in IgA nephropathy. Further, the dual-mechanism, B-cell-depleting antibody ianalumab is nearing the market after a pair of phase 3 wins in Sjögren’s, while a first-line ITP pivotal readout is expected this year. “Novartis continually assesses opportunities to adapt in alignment with our evolving pipeline, patient, and customer needs. As such, we direct our efforts and talent toward areas where we can create the greatest potential impact for patients and customers,” the company spokesperson said.  Novartis has made multiple cuts tied to its New Jersey HQ in the past few years. In September, it laid out a plan to lay off 58 employees in its U.S. medical affairs organization, following another overhaul of its cardiovascular commercial structure that affected 427 employees.The Swiss pharma has been steadily dialing back its U.S. workforce in recent years. Coinciding with the separation of the biosimilars and generics unit Sandoz, Novartis’ U.S. headcount, measured by full-time equivalents, dropped by nearly 12% year over year to 12,846 in 2023. As of the end of last year, the company had 12,556 full-time employees stateside. Globally, Novartis is only one of two large pharma companies that have consistently slimmed down every year between 2021 and 2025, according to a recent Fierce Pharma analysis.  While its U.S. commercial team and general and administrative functions have become smaller, Novartis beefed up its manufacturing headcount by 25% last year to 1,479 people. Following an industry-wide trend to avoid potential pharmaceutical tariffs by the Trump administration, Novartis last year unveiled a $23 billion investment to grow its U.S. footprint in production and R&D.  

临床上，血小板减少的判读不应仅看“数字”，更要看“形态”与“基因”。以下是针对五项核心检查的解读：血常规→外周血涂片→骨穿→骨髓活检→分子检测的结果解读。 第一步：血常规报告单（初筛与去伪） 拿到报告第一眼，先看“真伪”与“整体”。 看 PLT（血小板计数）与散点图： 异常表现：PLT 低，但机器提示"血小板聚集"。操作建议：立即观察散点图，若血小板区域出现拖尾或不规则分布，提示 EDTA 依赖性假性减少（PTCP）。对策：换用柠檬酸钠（蓝管）重测。 看 MPV（平均血小板体积）： 对照指标：若 PLT ↓ 且 MPV ↑，提示骨髓代偿良好，多为外周消耗（如 ITP）。若 MPV ↓，提示造血功能受抑。 看伴随指标： 单系减少：仅 PLT 低，多考虑 ITP。多系减少：伴有 Hb↓（贫血）或 WBC↓（白细胞低），需考虑 SLE 活动或骨髓受累。 第二步：外周血涂片—— 识别“危急值” 这是区分“免疫损伤”与“微血管病性消耗”的关键。 指标对照：报告单描述：可见“破碎红细胞”或“盔形红细胞”。定量标准：若占比 > 1%。临床结论： 极度警惕 TTP（血栓性血小板减少性紫癜）。操作导向： 观察患者有无发热、神经系统症状、肾损（TTP五联征）。紧急加做 ADAMTS13 活性检测。禁忌：在排除 TTP 前，严禁盲目输注血小板（可能加重血栓）。 第三步：骨髓穿刺—— 动力学“深度复核” 看的是“工厂”在忙什么。 指标对照（核心是巨核细胞系）：数量项：报告单显示“全片巨核细胞 > 35个/2cm × 3cm”。形态项：显示“颗粒巨核细胞占比高，产板巨核细胞显著减少（甚至为0）”。临床结论：成熟障碍。支持 ITP、SLE 或 APS 导致的免疫破坏。操作导向： 治疗侧重于“保成品、提产量”。可考虑应用激素、静丙，或 TPO 受体激动剂（如艾曲泊帕）。 第四步：骨髓活检—— 排除“地基塌陷” 看的是“厂房”是否被占领。 指标对照（造血面积与间质）：造血面积：正常为（100 - 年龄）%。若报告显示“< 25%”，且脂肪填充。结论：再生障碍性贫血（AA）。特殊描述：若见“网状纤维增生（MF-2或MF-3级）”。结论：骨髓纤维化（这在某些重症 SLE 中偶见）。操作导向： 若造血面积严重下降，免疫抑制治疗需更保守，警惕感染风险。 第五步：WT1 基因表达 —— 洞察“恶性伪装” 这是区分“炎症性减少”与“肿瘤性减少”的分子武器。 指标对照（分子报告）：正常参考：通常表达量应小于 0.6%。异常升高：WT1 拷贝数显著上调（例如高于正常上限数倍）。临床结论： 警惕 MDS（骨髓增生异常综合征）。操作导向：如果 WT1 高表达：即使患者目前看起来像 ITP，也不建议长期大剂量激素治疗，因为无效且可能掩盖病情。决策：必须联合血液科，考虑去甲基化药物治疗或造血干细胞移植。 总结：血常规→外周血涂片→骨穿→骨髓活检→分子检测“五维对照表” 于博士的建议： 在风湿科，我们常说“免疫是因，血小板低是果”。但加入 WT1 的维度后，我们多了一个反向思考：“骨髓变异是否才是深层原因？” 尤其对于难治性 SLE 伴三系减少，WT1 的高表达往往预示着疾病已从单纯的自身免疫演变为骨髓克隆性异常。 于水莲 挂号预约 于水莲医生介绍主任医师 中山大学孙逸仙纪念医院 风湿免疫科 @中山二院风湿免疫科 博士毕业于香港中文大学医学院 哈佛大学博士后、哈佛附属BIDMC医院风湿免疫中心研究员 欢迎报考我中山大学风湿免疫学硕士研究生 🔹 擅长方向 ① 生物制剂及小分子药靶向治疗：红斑狼疮、狼疮肾炎、类风湿关节炎、痛风性关节炎、强直性脊柱炎、银屑病关节炎、干燥综合征、血管炎、大动脉炎、硬皮病；② 疑难重症：白塞病、皮肌炎、肌炎、结缔组织病间质性肺炎；③ 微创痛风石清理术：水筋针、针刀镜快速清除痛风石；④ 前沿治疗：参与干细胞、CAR-T、CRA-NK、CAR-M等前沿技术在风湿免疫病中临床应用。 出诊地点：广州市越秀区沿江西路107号 中山大学孙逸仙纪念医院(北院区) 挂号点击：挂号预约 风湿前沿靶向治疗临床研究-招募信息（建议先门诊咨询评估) 急性痛风发作：生物制剂如何实现精准“断电”？【招募】中重度活动性类风湿关节炎患者 系统性红斑狼疮患者招募活动性银屑病关节炎患者招募干燥综合征患者招募ANCA相关性血管炎患者招募白塞病患者招募强直性脊柱炎患者招募 每月门诊排班：每周二、五上午、周三下午 具体详见中山大学孙逸仙纪念医院风湿免疫科2026年3月份门诊排班（含花都院区门诊安排） 于博士的医学科普：狼疮治疗新希望：正在研发中的生物制剂有哪些？类风湿新疗法：生物制剂？小分子药？如何选择风湿小课堂 | 生物制剂选药的底层逻辑止痛、降酸、防复发：一文看懂痛风三类常用药怎么选！生物制剂打破“降尿酸-痛风复发-停药”的恶性循环做有温度的风湿免疫病科普！风湿免疫病≠终点，让我们一起，用最科学的方法，最乐观的心态把病情管好！💪 于博士的公众号： 于博士的视频号 风湿内科于水莲医生 ，赞 24