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

• Published in: Clinical and applied thrombosis/hemostasis Vol. 27; p. 10760296211005555
• Main Authors: Ahmed, Hafiz Abdul Waqas, Masoud, Ahmed Taher, Han, Jia, Adel Sofy, Ahmed, Saeed Ahmed, Ahmed, Abdesattart, Ahmed Taha, Drokow, Emmanuel Kwateng, Sun, Kai
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 2021; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Meta-analysis; Original; Thrombocytopenia; chronic immune thrombocytopenia; thrombopoietin; immune thrombocytopenic purpura; thrombocytopenia; eltrombopag
• ISSN: 1076-0296; 1938-2723; 1938-2723
• DOI: 10.1177/10760296211005555

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).