Safety of non‑peptide thrombopoietin receptor agonists in patients with immune thrombocytopenia: A systematic review and meta‑analysis of short‑term double‑blind randomized clinical trials

Nan Shen; Jibing Qiao; Yazhou Jiang; Hanjun Yin; Min Li; Suyue Zhu; Jianqin Li

doi:10.3892/etm.2023.12092

Safety of non‑peptide thrombopoietin receptor agonists in patients with immune thrombocytopenia: A systematic review and meta‑analysis of short‑term double‑blind randomized clinical trials

Exp Ther Med. 2023 Jul 3;26(2):393. doi: 10.3892/etm.2023.12092. eCollection 2023 Aug.

Authors

Nan Shen^{1

2}, Jibing Qiao¹, Yazhou Jiang¹, Hanjun Yin¹, Min Li², Suyue Zhu¹, Jianqin Li²

Affiliations

¹ Department of Pediatrics, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian, Jiangsu 223800, P.R. China.
² Department of Hematology, The Children's Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China.

Abstract

The aim of the present study was to analyze the safety of non-peptide thrombopoietin receptor agonists (TPO-RAs) for immune thrombocytopenia (ITP) treatment. All studies reporting adverse events (AEs) in relation to ITP treatment with eltrombopag, avatrombopag, and hetrombopag were retrieved from PubMed, Web of Science, and Embase databases. RevMan 5.4.1 was used for meta-analysis, heterogeneity and bias analyses. A total of 1,078 patients from seven eligible studies were enrolled. In the enrolled clinical trials, the double-blind period was between 6 weeks and 6 months. The results revealed that the chances of any AEs [relative risk (RR)=1.16; 95% confidence interval (CI), 0.90-1.51; I²=78%; P=0.26], grade 3/4 AEs (RR=1.07; 95% CI, 0.63-1.80; I²=0%; P=0.81), elevated transaminase levels (RR=1.09; 95% CI, 0.68-1.74; I²=0%; P=0.72), thrombosis (RR=1.92; 95% CI, 0.55-6.66; I²=0%; P=0.31) and cataracts (RR=0.83; 95% CI, 0.38-1.83; I²=0%; P=0.65) were not significantly higher in patients with ITP that received non-peptide TPO-RAs compared with patients with ITP treated with a placebo. The present study indicated that non-peptide TPO-RAs were relatively safe for patients with ITP, at least within 6 months of administration.

Keywords: avatrombopag; eltrombopag; hetrombopag; immune thrombocytopenia; thrombopoietin receptor agonists.

Grants and funding

Funding: This study was supported by the Jiangsu Province Maternal and Child Health Research Project (grant nos. F201941 and F202153) and Suqian Science and Technology Plan Project (grant nos. Z2019154 and K202002).