Avatrombopag

(Doptelet®)

Doptelet®

Drug updated on 10/29/2024

Dosage FormTablet (oral; 20 mg)
Drug ClassThrombopoietin receptor agonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure
  • Indicated for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.

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Summary
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  • This summary is based on the review of 10 systematic review(s)/meta-analysis(es). [1-10]
  • Effectiveness of TPO-RAs in ITP: TPO-RAs were effective in treating immune thrombocytopenia (ITP) in adults, increasing platelet response rates, extending response duration, reducing bleeding events, and decreasing the need for rescue therapy compared to placebo. In children, results were consistent except for no significant reduction in the incidence of any bleeding.
  • Avatrombopag Compared to Other TPO-RAs: Avatrombopag showed a higher platelet response rate than eltrombopag and hetrombopag in adults. It also demonstrated the highest platelet response rate and the lowest risk of treatment-related adverse events (TRAEs) in network meta-analyses involving multiple TPO-RAs.
  • Durable Platelet Response and Bleeding Reduction: Avatrombopag significantly improved durable platelet response and reduced the use of concomitant ITP medication compared to placebo, with a notable reduction in bleeding events compared to eltrombopag and romiplostim.
  • Effectiveness in Network Meta-Analysis: Avatrombopag and lusutrombopag were the most effective TPO-RAs in achieving platelet response compared to placebo, with avatrombopag demonstrating superiority over several other treatments, including eltrombopag, romiplostim, and rituximab.
  • The incidence of thromboembolic events was not significantly higher in the TPO-RAs group compared to the control group, with no significant differences among romiplostim, eltrombopag, avatrombopag, and hetrombopag.
  • Non-peptide TPO-RAs, including avatrombopag, did not show a significantly higher risk of adverse events (AEs), grade 3/4 AEs, elevated transaminase levels, thrombosis, or cataracts compared to placebo in short-term studies (up to 6 months).
  • Avatrombopag had the lowest risk of treatment-related adverse events (TRAEs) among compared therapies, with no significant differences in TRAEs between eltrombopag, romiplostim, and avatrombopag.
  • There is no population type or subgroup information available in the reviewed studies.

Product Monograph / Prescribing Information

Document TitleYearSource
Doptelet (avatrombopag) Prescribing Information.2024Sobi, Inc., Waltham, MA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Thrombopoietin receptor agonists use and risk of thrombotic events in patients with immune thrombocytopenic purpura: A systematic review and meta‑analysis of randomized controlled trials2024Biomedical Reports
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 trials2023Experimental and Therapeutic Medicine
Risk of thrombotic events in immune thrombocytopenia patients treated with thrombopoietic agents: a systematic review and meta-analysis2023Thrombosis Journal
Efficacy and safety of thrombopoietin receptor agonists in children and adults with persistent and chronic immune thrombocytopenia: a meta-analysis2023Expert Opinion on Pharmacotherapy
Use of thrombopoietin receptor agonists in adults with immune thrombocytopenia: a systematic review and Central European expert consensus2023Annals of hematology
Efficacy and Incidence of Treatment-Related Adverse Events of Thrombopoietin Receptor Agonists in Adults with Immune Thrombocytopenia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Study2023Acta Haematologica
Comparative Efficacy and Safety of Thrombopoietin Receptor Agonists in Adults With Thrombocytopenia: A Systematic Review and Network Meta-analysis of Randomized Controlled Trial2021Frontiers in Pharmacology
Efficacy and Safety of Avatrombopag in Patients with Chronic Immune Thrombocytopenia: A Systematic Literature Review and Network Meta-Analysis2021Advances in Therapy
Thrombopoietin receptor agonists for the treatment of primary immune thrombocytopenia: a meta-analysis and systematic review2021Platelets
Therapeutic options for adult patients with previously treated immune thrombocytopenia - a systematic review and network meta-analysis2019Hematology

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