Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jan-Dec:27:10760296211005555.
doi: 10.1177/10760296211005555.

Eltrombopag Effectiveness and Tolerability in Chronic Immune Thrombocytopenia: A Meta-Analysis

Hafiz Abdul Waqas Ahmed  1 , Ahmed Taher Masoud  2 , Jia Han  3 , Ahmed Adel Sofy  2 , Ahmed Saeed Ahmed  2 , Ahmed Taha Abdesattart  2 , Emmanuel Kwateng Drokow  1 , Kai Sun  1
Affiliations
Meta-Analysis

Eltrombopag Effectiveness and Tolerability in Chronic Immune Thrombocytopenia: A Meta-Analysis

Hafiz Abdul Waqas Ahmed et al. Clin Appl Thromb Hemost. 2021 Jan-Dec.

Abstract

Eltrombopag is an orally administered, non-peptide, thrombopoietin receptor agonist which initiates thrombopoietin signaling and stimulates the production of normally functioning platelet. We aimed to do a systematic review and meta-analysis of currently available published data to verify whether eltrombopag treatment in patients with chronic immune-mediated thrombocytopenia can prolong survival. We searched for published, randomized, controlled trials in PubMed, Cochrane and Scopus databases using the following search strategy ("Eltrombopag" OR "Benzoates" OR "Hydrazines") AND ("Idiopathic Thrombocytopenic Purpura" OR "immune thrombocytopenia" OR "Idiopathic Thrombocytopenic Purpuras" OR "Immune Thrombocytopenia" OR "Autoimmune Thrombocytopenia" OR "Werlhof"). The pooled relative risk (RR) showed that eltrombopag group has significantly higher overall platelet response than placebo group (MD = 3.42, 95% CI [2.51, 4.65], P > .0001); pooled results were homogenous (P = .27, I2 = 22%). The pooled relative risk showed that eltrombopag group has lower incidence of any bleeding than placebo group (MD = 0.65, 95% CI [0.48, 0.87], P = .003); pooled results were heterogenous (P = .001, I2 = 75%) and the detected heterogeneity was best resolved after excluding Bussel et al (P = .10). Homogeneous results were still favored eltrombopag group (MD = 0.75, 95% CI [0.60, 0.93], P = .008).

Keywords: chronic immune thrombocytopenia; eltrombopag; immune thrombocytopenic purpura; thrombocytopenia; thrombopoietin.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA.
Figure 2.
Figure 2.
ROB. Risk of bias domain.
Figure 3.
Figure 3.
Platelet response and significant bleeding. (A) Overall platelet response and (B) incidence of significant bleeding.
Figure 4.
Figure 4.
A and B, Incidence of any bleeding.
Figure 5.
Figure 5.
Rescue treatment. Number of cases needed rescue treatment.
Figure 6.
Figure 6.
A and B, Any adverse event.
Figure 7.
Figure 7.
A and B, Serious adverse events.
See this image and copyright information in PMC

References

    1. Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an International Working Group. Blood. 2009;113(11):2386–2393. - PubMed
    1. Bussel JB, Cheng G, Saleh MN, et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. New Engl J Med. 2007;357(22):2237–2247. - PubMed
    1. Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829–3866. - PMC - PubMed
    1. Cheng G, Saleh MN, Marcher C, et al. Eltrombopag for management of chronic immune thrombocytopenia (RAISE): a 6-month, randomised, phase 3 study. Lancet. 2011;377(9763):393–402. - PubMed
    1. McMillan R, Durette C. Long-term outcomes in adults with chronic ITP after splenectomy failure. Blood. 2004;104(4):956–960. - PubMed

Publication types

MeSH terms

LinkOut - more resources