Transfusion Evidence Alert and Round-Up

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The Transfusion Evidence Alert is a monthly overview of the top ten evidence-based publications in the field of transfusion medicine. The articles are selected for quality and relevance by clinical experts, supported by members of the Systematic Review Initiative.

The Transfusion Evidence Round-Up is a quarterly overview of the top 10 high quality studies about an internationally relevant subject in the field of transfusion medicine. The articles are selected by members from the International Society of Blood Transfusion and drawn from the Transfusion Evidence Library and, where relevant, Stem Cell Evidence.

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Editor's Choice

Risk of thrombosis with thrombopoietin receptor agonists for ITP patients: A systematic review and meta-analysis

Crit Rev Oncol Hematol. 2022 Mar;171:103581 doi: 10.1016/j.critrevonc.2022.103581.
PICO Summary
POPULATION:

Adult patients with persistent or chronic immune thrombocytopenia patients (11 studies).

INTERVENTION:

Thrombopoietin receptor agonists (TPO-RA) therapy (TPO-RA group).

COMPARISON:

Placebo or standard of care (control group).

OUTCOME:

More thromboembolic events were noted in the TPO-RA group than in the control group: 25 events compared to 4 events respectively. Ten out of 11 studies showed a relative risk greater than 1. However, none of these individual risk ratios was statistically significant. The meta-analysis showed a RR of 1.82 (95 % CI: 0.78-4.24).

Abstract

One possible side effect of thrombopoietin receptor agonists in immune thrombocytopenia is thrombosis. Our aim is to systematically review whether patients with ITP that were treated with a TPO-RA have an increased risk for thrombosis as compared to ITP patients without TPO-RA. Patients in the intervention group were required to receive TPO-RA therapy. The primary outcome was the incidence of thromboembolic events. Eleven studies were included in the pooled analysis. More thromboembolic events were noted in the TPO-RA group than in the control group: 25 compared to 4. Ten out of 11 studies showed a relative risk greater than 1. However, none of these individual risk ratios was statistically significant. The meta-analysis showed a RR of 1.82 [95 % CI 0.78-4.24]. Our findings indicate there is a non-significant higher chance of thrombosis in ITP patients with TPO-RA treatments versus ITP patients without TPO-RA treatment.

Metadata
KEYWORDS: Eltrombopag; Immune thrombocytopenia; Romiplostim; Thrombopoietin receptor agonist; Thrombosis
MESH HEADINGS: Humans; Purpura, Thrombocytopenic, Idiopathic; Receptors, Thrombopoietin; Recombinant Fusion Proteins; Thrombopoietin; Thrombosis
Study Details
Study Design: Systematic Review
Language: eng
Credits: Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine