Title:Safety and Efficacy of Eltrombopag in Children and Adults with Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
Volume: 19
Issue: 1
Author(s): Savvas Kolanis, Eleni Vasileiou, Emmanuel Hatzipantelis, Marina Economou and Athanasios Tragiannidis*
Affiliation:
- 2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki,Greece
Keywords:
Immune thrombocytopenia, eltrombopag, thrombocytopenia, aplastic anemia, antibodies, megakaryocytes.
Abstract: 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 50x109/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; I2 = 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; I2 = 40%) (RR
0.74, 95% CI 0.62 to 0.89; I2 = 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; I2 = 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.