Efficacy and safety of thrombopoietin receptor agonists in children with chronic immune thrombocytopenic purpura: meta-analysis

Abstract

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting with low platelet count <100 × 10⁹/L. The condition affects both adults and children. Thrombopoietin receptor agonists (TPO-RAs) are second-line of therapy that includes Romiplostim and Eltrombopag, which stimulate the production of normally functioning platelets. Although the biological effect of these drugs is well established, there has not been a meta-analysis in children. To estimate the efficacy and safety of Romiplostim and Eltrombopag, we performed a systematic review and meta-analysis in children with chronic ITP. Systematic literature search was conducted in the following database: PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Review Manager 5.3 for Windows was used to analyze the data. Five randomized controlled trials with total of 261 pediatric patients from 1–17 years of age were included. The efficacy and safety analysis showed TPO-RA groups were superior over placebo, and there was no difference in adverse event occurrence between TPO-RA (Romiplostim and Eltrombopag) and placebo groups. The efficacy and safety of Eltrombopag did not differ significantly from those of Romiplostim. Both drugs were effective in treatment of children with chronic ITP. Our findings extend the currently available data on ITP treatment and is helpful for pediatric health providers and for the design of future clinical trials.

Keywords:

• Child
• eltrombopag
• immune thrombocytopenic purpura (ITP)
• romiplostim
• thrombopoietin receptor agonists(TPO-RA)

Acknowledgments

This study was supported by the grant of key clinical specialties of Fujian, China (2015-593).I would like to express my heartfelt gratitude to Professor Yonghua Zhu, who help language editing.

Declaration of interest statement

The authors report no conflicts of interest

Additional information

Funding

This work was supported by the the project of key clinical specialties of Fujian [2015-593].