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.