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

University Medical Center Groningen, Department of Hematology, the Netherlands. Haga Teaching Hospital, Department of Hematology, the Netherlands. Electronic address: s.amini@hagaziekenhuis.nl.

Critical reviews in oncology/hematology. 2022;:103581
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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.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine