2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
1st Department of Paediatrics, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Cardiovasc Hematol Agents Med Chem. 2021;19(1):83-92. doi: 10.2174/1871525718666200910161540.
Immune thrombocytopenia is an immune condition where antibodies are produced against platelets. Eltrombopag is a thrombopoietin receptor agonist that stimulates and promotes platelet production approved for treating thrombocytopenia in patients with chronic immune thrombocytopenia, where other treatments such as corticosteroids, splenectomy or immunoglobulins are inadequate. The aim of this meta-analysis was to evaluate the efficacy and safety of the eltrombopag in adults and children with immune thrombocytopenia. We included 7 studies with a total of 765 patients (606 adults and 159 children). We evaluated the number of patients that achieved a post-treatment platelet count equal or above 50x10/L (primary result-target) without the need of rescue treatment for at least 4 weeks. Our data showed that patients who received eltrombopag were almost 4 times more probable in achieving the primary target when compared to patients who received placebo (RR 3.84, 95% CI 2.39 to 6.14; I = 46%). The number of patients needed rescue treatment and the number of bleeding incidents were reduced in the group that received eltrombopag when compared to those who received placebo (RR 0.40, 95% CI 0.25 to 0.62; I = 40%) (RR 0.74, 95% CI 0.62 to 0.89; I = 68%). The total number of side effects did not statistically differ between the two groups (RR 0.99, 95% CI 0.90 to 1.08; I = 14%). Our findings were similar to previously published studies and confirm that eltrombopag is safe and efficient in immune thrombocytopenia. However, more clinical trials are needed in order to enhance our findings.
免疫性血小板减少症是一种免疫性疾病，其中会产生针对血小板的抗体。艾曲波帕是一种促血小板生成素受体激动剂，可刺激和促进血小板生成，已被批准用于治疗慢性免疫性血小板减少症患者的血小板减少症，对于其他治疗方法（如皮质类固醇、脾切除术或免疫球蛋白）无效的患者。本荟萃分析的目的是评估艾曲波帕治疗成人和儿童免疫性血小板减少症的疗效和安全性。我们纳入了 7 项研究，共 765 例患者（606 例成人和 159 例儿童）。我们评估了达到治疗后血小板计数等于或高于 50x10/L（主要结果目标）且至少 4 周无需挽救治疗的患者人数。我们的数据表明，与安慰剂组相比，接受艾曲波帕治疗的患者达到主要目标的可能性几乎高出 4 倍（RR 3.84，95%CI 2.39 至 6.14；I = 46%）。与安慰剂组相比，接受艾曲波帕治疗的患者需要挽救治疗的患者人数和出血事件的数量减少（RR 0.40，95%CI 0.25 至 0.62；I = 40%）（RR 0.74，95%CI 0.62 至 0.89；I = 68%）。两组的不良反应总数无统计学差异（RR 0.99，95%CI 0.90 至 1.08；I = 14%）。我们的发现与先前发表的研究相似，证实艾曲波帕在免疫性血小板减少症中安全且有效。然而，需要更多的临床试验来加强我们的发现。
