title: Efficacy and safety of thrombopoietin receptor agonists in patients with primary immune thrombocytopenia: A systematic review and meta-analysis.
abstract: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased platelet destruction and impaired platelet production. In this study, we conducted a systematic review and meta-analysis to determine the efficacy and safety of thrombopoietin receptor agonists (TPO-RAs) in primary ITP patients. Thirteen randomized controlled trials were included in this study, the pooled results of which demonstrated that TPO-RAs significantly increased platelet response (R) and durable response (DR) rates [risk ratio (RR): 2.77, 95% confidence interval (CI): 2.01-3.82, P = 5.9 × 10-10; RR: 7.52, 95% CI: 3.94-14.35, P = 9.2 × 10-10; respectively] and that TPO-RAs significantly reduced the incidences of any or severe bleeding events (RR: 0.80, 95% CI: 0.67-0.95, P = 0.013; RR: 0.52, 95% CI: 0.27-0.99, P = 0.048; respectively). Moreover, our results indicated that there was a significant reduction in the proportion of patients needing rescue medications in the TPO-RA groups compared with the control groups (RR: 0.50, 95% CI: 0.42-0.59, P = 2.0 × 10-15) and that the rates of any or severe adverse events were similar between the TPO-RA and control regimens (RR: 1.01, 95% CI: 0.92-1.10; RR: 0.74, 95% CI: 0.54-1.01; respectively). These findings demonstrate that TPO-RAs are an effective and safe second-line treatment option for primary ITP patients.
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.|Department of Hematology, Laoshan Branch, No. 401 Hospital of Chinese PLA, Qingdao, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.|Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Hematology, Navy General Hospital of Chinese PLA, Beijing, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Chen
authors.affiliation: Department of Hematology, Linyi People's Hospital, Linyi, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Yang
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Fei-Yan
authors.initials: FY
authors.lastname: Wang
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Li-Xun
authors.initials: LX
authors.lastname: Guan
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Zhen-Yang
authors.initials: ZY
authors.lastname: Gu
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Sha-Sha
authors.initials: SS
authors.lastname: Zhao
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Hua-Ping
authors.initials: HP
authors.lastname: Wei
authors.affiliation: Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
authors.forename: Chun-Ji
authors.initials: CJ
authors.lastname: Gao
mesh_terms: D001792:Blood Platelets / Q000378:metabolism*; D006801:Humans; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000378:metabolism*; D016032:Randomized Controlled Trials as Topic; D053628:Receptors, Thrombopoietin / Q000819:agonists*
chemical_list: D053628:Receptors, Thrombopoietin; C082218:MPL protein, human