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免疫性血小板减少症患儿的血小板生成素受体激动剂:一个新的治疗时代。

Thrombopoietin Receptor Agonists in Children with Immune Thrombocytopenia: A New Therapeutic Era.

作者信息

Lassandro Giuseppe, Palladino Valentina, Vecchio Giovanni C D, Palmieri Viviana V, Corallo Paola C, Faienza Maria F, Giordano Paola

机构信息

Department of Biomedical Science and Human Oncology-Pediatric Unit, University of Bari "Aldo Moro", Bari, Italy.

出版信息

Endocr Metab Immune Disord Drug Targets. 2021;21(3):397-406. doi: 10.2174/1871530320666200531142244.

Abstract

BACKGROUND AND OBJECTIVE

Immune thrombocytopenia (ITP) is a common bleeding disorder in childhood. The management of ITP in children is controversial, requiring personalized assessment of patients and therapeutic choices. Thrombopoietin receptor agonists (TPO-RAs), eltrombopag and romiplostim, have been shown to be safe and effective for the treatment of pediatric ITP. The aim of our research is to define the role of thrombopoietin receptor agonists in the management of pediatric ITP.

METHODS

This review focuses on the use of TPO-RAs in pediatric ITP, in randomized trials and in clinical routine, highlighting their key role in the management of the disease.

RESULTS

Eltrombopag and romiplostim appear effective treatment options for children with ITP. Several clinical studies have assessed that the use of TPO-RAs increases platelet count, decreases bleeding symptoms and improves health-related quality of life. Moreover, TPO-RAs are well tolerated with minor side effects.

CONCLUSION

Although long term efficacy and safety of TPO-RAs still require further investigations, their use is gradually expanding in the clinical practice of children with ITP.

摘要

背景与目的

免疫性血小板减少症(ITP)是儿童常见的出血性疾病。儿童ITP的治疗存在争议,需要对患者进行个性化评估并做出治疗选择。血小板生成素受体激动剂(TPO-RAs),即艾曲泊帕和罗米司亭,已被证明对治疗儿童ITP安全有效。我们研究的目的是确定血小板生成素受体激动剂在儿童ITP治疗中的作用。

方法

本综述聚焦于TPO-RAs在儿童ITP中的应用,包括随机试验和临床常规应用,突出其在该疾病治疗中的关键作用。

结果

艾曲泊帕和罗米司亭似乎是ITP患儿有效的治疗选择。多项临床研究评估发现,使用TPO-RAs可增加血小板计数、减轻出血症状并改善健康相关生活质量。此外,TPO-RAs耐受性良好,副作用较小。

结论

尽管TPO-RAs的长期疗效和安全性仍需进一步研究,但它们在儿童ITP临床实践中的应用正在逐渐扩大。

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