TPO receptor agonist for chronic idiopathic thrombocytopenic purpura

Cochrane Database of Systematic Reviews, 2011

TPO receptor agonist for chronic idiopathic thrombocytopenic purpura - The Cochrane Library - Zeng - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content TPO receptor agonist for chronic idiopathic thrombocytopenic purpura Yan Zeng 2,† , Xin Duan 1,* , Jiajun Xu 3 , Xun Ni 2 Editorial Group: Published Online: 6 JUL 2011 Assessed as up-to-date: 4 MAY 2010 DOI: 10.1002/14651858.CD008235.pub2 Copyright © 2011 The Cochrane Collaboration.
Publication History Publication Status: New Published Online: 6 JUL 2011 SEARCH ARTICLE TOOLS Abstract Abstract Background Chronic idiopathic thrombocytopenic purpura (ITP) is an acquired autoimmune disorder that is characterized predominantly by a low platelet count.
Thrombopoietin (TPO) receptor agonists increase production of platelets by stimulating the TPO receptor in people with chronic ITP.
Objectives To determine the efficacy and safety of TPO receptor agonists in chronic ITP patients.
Search methods We searched MEDLINE (from 1950 to March 2011), EMBASE (from 1974 to March 2011), and the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2011, Issue 3) to identify all randomized trials in chronic ITP.
Selection criteria Randomized controlled trials (RCTs) comparing TPO receptor agonists alone, or in combination with other drugs, to placebo, no treatment, other drugs, splenectomy or another TPO receptor agonist in patients with chronic ITP.
Data collection and analysis Two review authors independently screened papers, extracted data and assessed the risk of bias in the included studies.
Five studies compared TPO receptor agonists with placebo (romiplostim: 100, eltrombopag: 299, placebo: 175); one study compared TPO receptor agonists with standard of care (SOC) (romiplostim: 157; SOC: 77).
SOC included a variety of therapies, such as glucocorticoid, anti-D immune globulin, intravenous immune globulin, rituximab, azathioprine, and so on.
Overall survival, one of our primary outcomes, was not studied by these RCTs and we could not estimate number needed to treat (NNT).
Another primary outcome, improving significant bleeding events, did not reveal any significant differences between the TPO receptor agonists group and the control group (placebo or SOC) (versus placebo risk ratio (RR) 0.48, 95% confidence interval (CI) 0.20 to 1.15; versus SOC RR 0.49, 95% CI 0.15 to 1.63).