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接受罗米司亭治疗的成人原发性免疫性血小板减少症患者皮质类固醇使用量减少

Reduced corticosteroid use in adult patients with primary immune thrombocytopenia receiving romiplostim.

作者信息

Michel Marc, te Boekhorst Peter A W, Janssens Ann, Pabinger-Fasching Ingrid, Sanz Miguel A, Nie Kun, Kreuzbauer Georg

机构信息

CHU Henri Mondor AP-HP, Université Paris, 51 Av du Mal de Lattre de Tassigny, Créteil, France.

出版信息

Hematology. 2011 Sep;16(5):274-7. doi: 10.1179/102453311X13025568942005.

DOI:10.1179/102453311X13025568942005
PMID:21902890
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3178451/
Abstract
Adult patients with primary immune thrombocytopenia requiring first-line treatment typically receive corticosteroids, which are associated with low response rates and many potential side effects. In a retrospective analysis of two 6-month, placebo-controlled, phase III trials, corticosteroid use decreased from 30 to 26% among patients treated with the novel thrombopoietin-mimetic romiplostim (n = 83) and remained above 30% for placebo-treated patients (n = 42). Moreover, compared to placebo, patients were spared 7 weeks of corticosteroid treatment for every 100 weeks of romiplostim treatment. Thereafter, corticosteroid use continued to decrease significantly, from 35 to 20%, in patients treated with romiplostim for up to 3 years in an open-label extension study (n = 101), and patients were spared a further 8 weeks of corticosteroid treatment for each additional 100 weeks of romiplostim treatment. Such reductions in corticosteroids may improve health-related quality of life in patients with primary immune thrombocytopenia.</div></div></div><div class="flex-1"><div class="pb-4 text-xl"><strong>摘要</strong></div><div class="markdown-body text-base"><h4>标题</h4> <p>成人原发性免疫性血小板减少症患者一线治疗通常使用皮质类固醇，但缓解率低且有许多潜在副作用。在两项为期6个月、安慰剂对照的III期试验的回顾性分析中，使用新型促血小板生成素模拟物罗米司亭治疗的患者（n = 83）中，皮质类固醇的使用从30%降至26%，而接受安慰剂治疗的患者（n = 42）中这一比例仍高于30%。此外，与安慰剂相比，每接受100周罗米司亭治疗，患者可减少7周的皮质类固醇治疗。此后，在一项开放标签扩展研究（n = 101）中，接受罗米司亭治疗长达3年的患者中，皮质类固醇的使用继续显著下降，从35%降至20%，每额外接受100周罗米司亭治疗，患者可再减少8周的皮质类固醇治疗。皮质类固醇的这种减少可能会改善原发性免疫性血小板减少症患者与健康相关的生活质量。</p> </div></div></div><div class="max-w-2xl mx-auto pb-20 px-8 lg:px-0"><div class="slick-slider slick-initialized" dir="ltr"><button type="button" data-role="none" class="slick-arrow slick-prev" style="display:block"> <!-- -->Previous</button><div class="slick-list"><div class="slick-track" style="width:500%;left:-100%"><div data-index="-1" tabindex="-1" class="slick-slide slick-cloned" 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dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-6 w-32 mb-4 rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="mb-4 flex flex-col gap-4 text-sm overflow-hidden"><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 inline-block min-w-5 h-5 shrink-0 rounded-full"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="flex-1 -mt-1 space-y-2"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-4 w-full rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-3 w-2/3 rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div></div></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 inline-block min-w-5 h-5 shrink-0 rounded-full"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="flex-1 -mt-1 space-y-2"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-4 w-full rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-3 w-2/3 rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div></div></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 inline-block min-w-5 h-5 shrink-0 rounded-full"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="flex-1 -mt-1 space-y-2"><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-4 w-full rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div><div class="group relative overflow-hidden bg-content3 dark:bg-content2 pointer-events-none before:opacity-100 before:absolute before:inset-0 before:-translate-x-full before:animate-[shimmer_2s_infinite] before:border-t before:border-content4/30 before:bg-gradient-to-r before:from-transparent before:via-content4 dark:before:via-default-700/10 before:to-transparent after:opacity-100 after:absolute after:inset-0 after:-z-10 after:bg-content3 dark:after:bg-content2 data-[loaded=true]:pointer-events-auto data-[loaded=true]:overflow-visible data-[loaded=true]:!bg-transparent data-[loaded=true]:before:opacity-0 data-[loaded=true]:before:-z-10 data-[loaded=true]:before:animate-none data-[loaded=true]:after:opacity-0 transition-background !duration-300 h-3 w-2/3 rounded"><div class="opacity-0 group-data-[loaded=true]:opacity-100 transition-opacity motion-reduce:transition-none !duration-300"></div></div></div></div></div></div></div><!--/$--><!--/$--></div><div class="w-full md:w-64 flex-shrink-0 sticky top-4 self-start"><div class="space-y-4"><div class="bg-card p-4 rounded-lg border relative"><h4 class="text-sm text-center mb-2 font-medium">文献AI研究员</h4><div class="w-10 h-10 rounded-2xl bg-muted-foreground/10 mx-auto flex items-center justify-center mb-2 gap-2"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-brain-circuit w-6 h-6 text-secondary-foreground" aria-hidden="true"><path d="M12 5a3 3 0 1 0-5.997.125 4 4 0 0 0-2.526 5.77 4 4 0 0 0 .556 6.588A4 4 0 1 0 12 18Z"></path><path d="M9 13a4.5 4.5 0 0 0 3-4"></path><path d="M6.003 5.125A3 3 0 0 0 6.401 6.5"></path><path d="M3.477 10.896a4 4 0 0 1 .585-.396"></path><path d="M6 18a4 4 0 0 1-1.967-.516"></path><path d="M12 13h4"></path><path d="M12 18h6a2 2 0 0 1 2 2v1"></path><path d="M12 8h8"></path><path d="M16 8V5a2 2 0 0 1 2-2"></path><circle cx="16" cy="13" r=".5"></circle><circle cx="18" cy="3" r=".5"></circle><circle cx="20" cy="21" r=".5"></circle><circle cx="20" cy="8" r=".5"></circle></svg></div><p class="text-sm text-foreground mb-3 text-center">20分钟写一篇综述，助力文献阅读效率提升50倍。</p><a class="inline-flex items-center justify-center gap-2 whitespace-nowrap rounded-md text-sm font-medium transition-colors focus-visible:outline-none focus-visible:ring-1 focus-visible:ring-ring disabled:pointer-events-none disabled:opacity-50 [&_svg]:pointer-events-none [&_svg]:size-4 [&_svg]:shrink-0 bg-primary text-primary-foreground 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Netherlands)\"},\"image\":[\"https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c25c/3178451/636d6a7b8f9d/hem-16-05-274-f01.jpg\",\"https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c25c/3178451/7ef02b473197/hem-16-05-274-f02.jpg\"],\"doi\":\"10.1179/102453311X13025568942005\"}2a:T416,\u003ctitle/\u003e Adult patients with primary immune thrombocytopenia requiring first-line treatment typically receive corticosteroids, which are associated with low response rates and many potential side effects. 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Epub 2015 Sep 24.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">7</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/29767837"><span class="text-base font-medium text-foreground">Romiplostim for the management of perioperative thrombocytopenia.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭在围手术期血小板减少症管理中的应用。</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Br J Haematol. 2018 Jul;182(1):106-113. doi: 10.1111/bjh.15280. Epub 2018 May 16.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">8</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/24036490"><span class="text-base font-medium text-foreground">Use of peptide thrombopoietin receptor agonist romiplostim (Nplate) in a case of primary HIV-associated thrombocytopenia.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>肽类血小板生成素受体激动剂罗米司亭（Nplate）在一例原发性HIV相关血小板减少症中的应用。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">J Int Assoc Provid AIDS Care. 2014 Jan-Feb;13(1):22-3. doi: 10.1177/2325957413502539. Epub 2013 Sep 13.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">9</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/29242295"><span class="text-base font-medium text-foreground">The use of romiplostim in treating chemotherapy-induced thrombocytopenia in patients with solid tumors.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭在实体瘤患者化疗所致血小板减少症治疗中的应用。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Haematologica. 2018 Apr;103(4):e169-e172. doi: 10.3324/haematol.2017.180166. Epub 2017 Dec 14.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">10</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/23676646"><span class="text-base font-medium text-foreground">[Progression of bone marrow fibrosis with reticulin and collagen hyperplasia during treatment with the thrombopoietin receptor agonist romiplostim in a patient with immune thrombocytopenia].</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>[免疫性血小板减少症患者使用血小板生成素受体激动剂罗米司亭治疗期间伴网状纤维和胶原增生的骨髓纤维化进展] </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Rinsho Ketsueki. 2013 Mar;54(3):295-9.</span></div></div><span></span></div></div></div><div class="mb-6"><h2 class="pb-4 font-semibold text-lg">引用本文的文献</h2><div class="mb-4 flex flex-col gap-4 text-sm overflow-hidden"><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">1</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/40766282"><span class="text-base font-medium text-foreground">Japanese database analysis: effectiveness of early initiation of TPO-RA treatment in tapering corticosteroid dose in ITP.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>日本数据库分析：TPO-RA治疗早期启动对成人免疫性血小板减少症患者糖皮质激素剂量递减的有效性</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Blood Vessel Thromb Hemost. 2025 Mar 24;2(2):100066. doi: 10.1016/j.bvth.2025.100066. eCollection 2025 May.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">2</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/36826482"><span class="text-base font-medium text-foreground">Use of thrombopoietin receptor agonists in adults with immune thrombocytopenia: a systematic review and Central European expert consensus.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>成人免疫性血小板减少症中血小板生成素受体激动剂的应用：系统评价和中欧专家共识。</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Ann Hematol. 2023 Apr;102(4):715-727. doi: 10.1007/s00277-023-05114-8. Epub 2023 Feb 24.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">3</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/34466771"><span class="text-base font-medium text-foreground">Corticosteroid overuse in adults with immune thrombocytopenia: Cause for concern.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>成人免疫性血小板减少症中皮质类固醇的过度使用：值得关注的问题。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Res Pract Thromb Haemost. 2021 Aug 25;5(6):e12592. doi: 10.1002/rth2.12592. eCollection 2021 Aug.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">4</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/25632241"><span class="text-base font-medium text-foreground">Romiplostim as a treatment for immune thrombocytopenia: a review.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭治疗免疫性血小板减少症的综述</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">J Blood Med. 2015 Jan 19;6:37-44. doi: 10.2147/JBM.S47240. eCollection 2015.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">5</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/23857462"><span class="text-base font-medium text-foreground">Cost effectiveness of romiplostim for the treatment of chronic immune thrombocytopenia in Ireland.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭治疗爱尔兰慢性免疫性血小板减少症的成本效益</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Appl Health Econ Health Policy. 2013 Oct;11(5):457-69. doi: 10.1007/s40258-013-0044-y.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">6</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/23664510"><span class="text-base font-medium text-foreground">Thrombopoietin receptor agonists in primary immune thrombocytopenia.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>血小板生成素受体激动剂在原发免疫性血小板减少症中的应用。</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Semin Hematol. 2013 Jan;50 Suppl 1(0 1):S18-21. doi: 10.1053/j.seminhematol.2013.03.005.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">7</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/23275229"><span class="text-base font-medium text-foreground">Successful treatment of eltrombopag-resistant refractory immune thrombocytopenia with romiplostim.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>用罗米司亭成功治疗艾曲泊帕耐药的难治性免疫性血小板减少症。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Int J Hematol. 2013 Feb;97(2):291-3. doi: 10.1007/s12185-012-1253-0. Epub 2012 Dec 29.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">8</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/22316355"><span class="text-base font-medium text-foreground">Romiplostim: a review of its use in immune thrombocytopenia.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭：在免疫性血小板减少症中的应用评价。</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Drugs. 2012 Feb 12;72(3):415-35. doi: 10.2165/11208260-000000000-00000.</span></div></div><span></span></div></div></div><div class="mb-6"><h2 class="pb-4 font-semibold text-lg">本文引用的文献</h2><div class="mb-4 flex flex-col gap-4 text-sm overflow-hidden"><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">1</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/19846889"><span class="text-base font-medium text-foreground">International consensus report on the investigation and management of primary immune thrombocytopenia.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>国际原发性免疫性血小板减少症诊治共识报告</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Blood. 2010 Jan 14;115(2):168-86. doi: 10.1182/blood-2009-06-225565. Epub 2009 Oct 21.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">2</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/19569197"><span class="text-base font-medium text-foreground">Quantifying the reduction in immunoglobulin use over time in patients with chronic immune thrombocytopenic purpura receiving romiplostim (AMG 531).</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>对接受罗米司亭（AMG 531）治疗的慢性免疫性血小板减少性紫癜患者随时间推移免疫球蛋白使用量的减少进行量化。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Am J Hematol. 2009 Aug;84(8):538-40. doi: 10.1002/ajh.21463.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">3</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/19553811"><span class="text-base font-medium text-foreground">Thrombopoietin receptor agonists in the treatment of thrombocytopenia.</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Curr Opin Hematol. 2009 Sep;16(5):357-64. doi: 10.1097/MOH.0b013e32832e06e4.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">4</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/19466980"><span class="text-base font-medium text-foreground">Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>慢性免疫性血小板减少症的发病机制：血小板破坏增加和/或血小板生成减少。</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Br J Haematol. 2009 Sep;146(6):585-96. doi: 10.1111/j.1365-2141.2009.07717.x. Epub 2009 May 14.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">5</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/19005182"><span class="text-base font-medium text-foreground">Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>成人及儿童免疫性血小板减少性紫癜术语、定义及疗效标准的标准化：国际工作组报告 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Blood. 2009 Mar 12;113(11):2386-93. doi: 10.1182/blood-2008-07-162503. Epub 2008 Nov 12.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">6</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/18981291"><span class="text-base font-medium text-foreground">Safety and efficacy of long-term treatment with romiplostim in thrombocytopenic patients with chronic ITP.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭长期治疗慢性免疫性血小板减少症血小板减少患者的安全性和有效性。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Blood. 2009 Mar 5;113(10):2161-71. doi: 10.1182/blood-2008-04-150078. Epub 2008 Nov 3.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">7</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/18457458"><span class="text-base font-medium text-foreground">Novel thrombopoietic agents: a review of their use in idiopathic thrombocytopenic purpura.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>新型血小板生成剂：其在特发性血小板减少性紫癜中的应用综述 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Drugs. 2008;68(7):901-12. doi: 10.2165/00003495-200868070-00002.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">8</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/18349741"><span class="text-base font-medium text-foreground">The epidemiology of glucocorticoid-associated adverse events.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>糖皮质激素相关不良事件的流行病学</span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Curr Opin Rheumatol. 2008 Mar;20(2):131-7. doi: 10.1097/BOR.0b013e3282f51031.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">9</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/18261217"><span class="text-base font-medium text-foreground">Impact of chronic Immune Thrombocytopenic Purpura (ITP) on health-related quality of life: a conceptual model starting with the patient perspective.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>慢性免疫性血小板减少性紫癜（ITP）对健康相关生活质量的影响：一个从患者角度出发的概念模型。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Health Qual Life Outcomes. 2008 Feb 8;6:13. doi: 10.1186/1477-7525-6-13.</span></div></div><span></span></div><div class="relative flex p-3 rounded-lg bg-card justify-between items-start gap-x-1 dark:hover:bg-neutral-700 hover:bg-secondary"><span class="bg-neutral-300 dark:bg-neutral-700 text-foreground inline-block px-1 min-w-5 h-5 shrink-0 leading-5 text-center text-xs rounded-full mr-1">10</span><div class="flex-1 -mt-1"><a class="text-primary flex flex-col" target="_self" href="/browses/detail/pubmed/18242413"><span class="text-base font-medium text-foreground">Efficacy of romiplostim in patients with chronic immune thrombocytopenic purpura: a double-blind randomised controlled trial.</span><span class="text-sm"><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-languages inline-flex size-3.5 mr-1" aria-hidden="true"><path d="m5 8 6 6"></path><path d="m4 14 6-6 2-3"></path><path d="M2 5h12"></path><path d="M7 2h1"></path><path d="m22 22-5-10-5 10"></path><path d="M14 18h6"></path></svg>罗米司亭治疗慢性免疫性血小板减少性紫癜患者的疗效：一项双盲随机对照试验。 </span></a><div class="flex items-center text-xs"><span class="text-muted-foreground">Lancet. 2008 Feb 2;371(9610):395-403. doi: 10.1016/S0140-6736(08)60203-2.</span></div></div><span></span></div></div></div></div></div><script>$RC=function(b,c,e){c=document.getElementById(c);c.parentNode.removeChild(c);var a=document.getElementById(b);if(a){b=a.previousSibling;if(e)b.data="$!",a.setAttribute("data-dgst",e);else{e=b.parentNode;a=b.nextSibling;var f=0;do{if(a&&8===a.nodeType){var d=a.data;if("/$"===d)if(0===f)break;else f--;else"$"!==d&&"$?"!==d&&"$!"!==d||f++}d=a.nextSibling;e.removeChild(a);a=d}while(a);for(;c.firstChild;)e.insertBefore(c.firstChild,a);b.data="$"}b._reactRetry&&b._reactRetry()}};$RC("B:0","S:0")</script></body></html>