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Review
. 2023 Jun 6;12(12):3872.
doi: 10.3390/jcm12123872.

Eltrombopag for Adults and Children with Immune-Refractory Thrombocytopenic Purpura: A Systematic Review

Danielle Francisco Honorato de Barros Torelli  1   2   3 , Crystian Bitencourt Soares Oliveira  1   2 , Gisele Alborghetti Nai  1 , Evelinda Marramon Trindade  4   5 , Luiz Euribel Prestes-Carneiro  1   2   3
Affiliations
Review

Eltrombopag for Adults and Children with Immune-Refractory Thrombocytopenic Purpura: A Systematic Review

Danielle Francisco Honorato de Barros Torelli et al. J Clin Med. .

Abstract

Eltrombopag is an agonist that binds to the membrane-bound domain of the thrombopoietin receptor used in immune thrombocytopenic purpura (ITP). We conducted a meta-analysis of randomized controlled trials to assess the efficacy and safety of eltrombopag in adults and children with refractory ITP. Adults who received eltrombopag had a significantly better platelet response (relative risk [RR], 3.65; 95% confidence interval [CI], 2.39-5.55), but there were no differences in the incidence of bleeding (RR, 0.8; 95% CI, 0.52-1.22) and adverse effects (RR, 0.99; 95% CI, 0.55-1.78) compared with the placebo. In children, there was no difference between eltrombopag and placebo for a platelet response >50,000/mm3 (RR, 3.93; 95% CI, 0.56-27.79) and the number of adverse events (RR, 0.99; 95% CI, 0.25-1.49); however, a lower incidence of bleeding was observed (RR, 0.47; 95% CI, 0.27-0.83). Treatment with eltrombopag protected adults and children from severe disease and death.

Keywords: blood coagulation; erythropoietin receptors; hematologic drugs; immune thrombocytopenic purpura; systematic review.

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Conflict of interest statement

The authors report that there are no competing interest to declare.

Figures

Figure 1
Figure 1
Flowchart of the studies included in the systematic review. ITP, immune thrombocytopenic purpura.
Figure 2
Figure 2
Risk of bias summary. The authors’ judgment for each study. Green, low risk of bias; yellow, uncertain risk [7,8,21,22,23,24,25,26,27].
Figure 3
Figure 3
Comparison of the lasting response with eltrombopag and placebo in adults and children with immune thrombocytopenic purpura [7,21,24].
Figure 4
Figure 4
Comparison between the occurrence of adverse events with eltrombopag and placebo in adults and children with immune thrombocytopenic purpura [7,8,22,23,24,25,26].
Figure 5
Figure 5
Comparison between the platelet response with eltrombopag and placebo in adults and children with immune thrombocytopenic purpura [7,8,21,22,23,24,25,26,27].
Figure 6
Figure 6
Comparison between the use of eltrombopag rescue therapy and placebo in adults and children with immune thrombocytopenic purpura [7,21,23,24,25,27].
Figure 7
Figure 7
Comparison between the occurrence of bleeding with eltrombopag and placebo in adults and children with immune thrombocytopenic purpura [7,8,21,22,23,24,25,26].
See this image and copyright information in PMC

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