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Use of thrombopoietin receptor agonists in adults with immune thrombocytopenia: a systematic review and Central European expert consensus.
Pulanic, Drazen; Bátorová, Angelika; Bodó, Imre; Cervinek, Libor; Ionita, Ioana; Lissitchkov, Toshko; Melikyan, Anahit; Podolak-Dawidziak, Maria.
  • Pulanic D; Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb, School of Medicine, Kispaticeva 12, 10 000, Zagreb, Croatia. dpulanic@yahoo.com.
  • Bátorová A; Department of Hematology and Transfusion Medicine, National Hemophilia Center, Faculty of Medicine of Comenius University and University Hospital Bratislava, Bratislava, Slovakia.
  • Bodó I; 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
  • Cervinek L; Faculty Hospital Brno, Department of Internal Medicine - Hematology and Oncology, Masaryk University, Brno, Czech Republic.
  • Ionita I; Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, HematologyTimisoara, Romania.
  • Lissitchkov T; Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria.
  • Melikyan A; Department of Standardization of Treatment Methods, National Research Center for Hematology Russian Federation, Moscow, Russia.
  • Podolak-Dawidziak M; Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
Ann Hematol ; 102(4): 715-727, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2277091
ABSTRACT
There are currently three thrombopoietin receptor agonists (TPO-RAs) approved in Europe for treating patients with immune thrombocytopenia (ITP) romiplostim (Nplate®), eltrombopag (Revolade®), and avatrombopag (Doptelet®). However, comparative clinical data between these TPO-RAs are limited. Therefore, the purpose of this study was to perform a literature review and seek expert opinion on the relevance and strength of the evidence concerning the use of TPO-RAs in adults with ITP. A systematic search was conducted in PubMed and Embase within the last 10 years and until June 20, 2022. A total of 478 unique articles were retrieved and reviewed for relevance. The expert consensus panel comprised ITP senior hematologists from eight countries across Central Europe. The modified Delphi method, consisting of two survey rounds, a teleconference and email correspondence, was used to reach consensus. Forty articles met the relevancy criteria and are included as supporting evidence, including five meta-analyses analyzing all three European-licensed TPO-RAs and comprising a total of 31 unique randomized controlled trials (RCTs). Consensus was reached on seven statements for the second-line use of TPO-RAs in the management of adult ITP patients. In addition, the expert panel discussed TPO-RA treatment in chronic ITP patients with mild/moderate COVID-19 and ITP patients in the first-line setting but failed to reach consensus. This work will facilitate informed decision-making for healthcare providers treating adult ITP patients with TPO-RAs. However, further studies are needed on the use of TPO-RAs in the first-line setting and specific patient populations.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Purpura, Thrombocytopenic, Idiopathic / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adult / Humans Language: English Journal: Ann Hematol Journal subject: Hematology Year: 2023 Document Type: Article Affiliation country: S00277-023-05114-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Purpura, Thrombocytopenic, Idiopathic / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adult / Humans Language: English Journal: Ann Hematol Journal subject: Hematology Year: 2023 Document Type: Article Affiliation country: S00277-023-05114-8