Summary

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• Avatrombopag (Doptelet) is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease scheduled to undergo a procedure and those with chronic immune thrombocytopenia who have had an insufficient response to previous treatments.
• A total of 13 systematic reviews and meta-analyses were reviewed, focusing on avatrombopag's safety and effectiveness compared to other drugs.
• Avatrombopag shows superior efficacy in achieving overall and durable platelet response compared to eltrombopag and hetrombopag, with comparable results to romiplostim.
• The incidence of serious adverse events (AEs) in avatrombopag-treated patients does not significantly differ from placebo; however, overall AEs are slightly higher but do not increase the risk of thrombotic events significantly when compared to other TPO-RAs like romiplostim or eltrombopag.
• Most studies consider adult populations for both chronic immune thrombocytopenia and chronic liver disease. There is limited data involving children primarily focused on adults' evaluations.
• In preprocedural use for patients with chronic liver disease, avatrombopag effectively increases preoperative platelet counts while decreasing the need for platelet transfusions without increasing bleeding risks or thrombotic events.
• Combining TPO-RAs such as avatrombopag with other treatments like rituximab enhances therapeutic outcomes in severe ITP cases by achieving higher efficacy rates than monotherapy regimens alone.