Department of Hematopathology, Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
Department of Cardiology, Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
Hematology. 2024 Dec;29(1):2335419. doi: 10.1080/16078454.2024.2335419. Epub 2024 Mar 30.
This article conducts a systematic review of eltrombopag combined with immunosuppressive therapy for the treatment of aplastic anemia (AA), to demonstrate the effectiveness and safety of eltrombopag.
PubMed, Cochrane Library, Embase, OVID, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were searched. Studies that met the inclusion criteria were collected, ranging from the establishment of the database to August 2023. Two reviewers performed meta-analyses using the Cochrane systematic review method and RevMan 5.3 software.
This meta-analysis enrolled 5 studies with a total of 542 AA patients, including 274 in the experimental group and 268 in the control group. Meta-analyses were performed for efficacy and adverse reactions. The endpoint of effects included 6-month complete response (CR), 6-month partial response (PR), and 6-month overall response (OR). Eltrombopag combined with immunotherapy showed significant improvements in 6-month CR (OR: 2.20; 95% CI;1.54-3.12; < 0.0001) and 6-month OR (OR = 3.66, 95% CI 2.39-5.61, < 0.001)compared to immunosuppressive therapy for AA patients. In terms of safety, eltrombopag combined with immunosuppressive therapy showed significantly increased pigment deposition and abnormal liver function compared to immunosuppressive therapy alone.
Compared to immunosuppressive therapy alone, eltrombopag combined with immunosuppressive therapy showed significant improvements in 6-month CR and 6-month OR. However, it also resulted in increased pigment deposition and abnormal liver function in terms of safety.
本文对血小板生成素受体激动剂（TPO-RA）联合免疫抑制治疗再生障碍性贫血（AA）进行系统评价，以明确 TPO-RA 治疗 AA 的有效性和安全性。
计算机检索 PubMed、Cochrane Library、Embase、OVID、Web of Science、中国知网（CNKI）、万方数据库，搜集 TPO-RA 联合免疫抑制治疗 AA 的随机对照试验（RCT），检索时限均从建库至 2023 年 8 月。由 2 位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用 Cochrane 系统评价方法和 RevMan 5.3 软件进行 Meta 分析。
共纳入 5 项 RCT，包含 542 例 AA 患者，试验组 274 例，对照组 268 例。Meta 分析结果显示：①疗效方面，TPO-RA 联合免疫抑制治疗 AA 患者的 6 个月完全缓解（CR）率[OR=2.20，95%CI（1.54，3.12），P<0.0001]和 6 个月总反应率（OR=3.66，95%CI（2.39，5.61），P<0.001）均显著高于免疫抑制治疗。②安全性方面，TPO-RA 联合免疫抑制治疗较免疫抑制治疗更易发生色素沉着[OR=3.54，95%CI（2.06，6.08），P<0.0001]和肝功能异常[OR=3.22，95%CI（1.69，6.15），P=0.0006]。
与免疫抑制治疗相比，TPO-RA 联合免疫抑制治疗可显著提高 AA 患者的 6 个月 CR 率和 6 个月 OR 率，但安全性方面更易发生色素沉着和肝功能异常。
