ArticleBiomedical reports2024
Thrombopoietin receptor agonists use and risk of thrombotic events in patients with immune thrombocytopenic purpura: A systematic review and meta‑analysis of randomized controlled trials.
Article in Biomedical reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- The thrombotic burden of high-risk immune thrombocytopenia patients receiving second-line treatments: a systematic review.Rheumatology (Oxford, England) · 2026Pooled it
- Pooled it
- Transient ST-segment elevation following coronary artery bypass grafting in a patient with immune thrombocytopenia treated with romiplostim: a case report.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Article
- A Paradoxical Case of Bleeding and Clots: The Hidden Thrombotic Threat in Immune Thrombocytopenic Purpura.Clinical case reports · 2026Article
- Review
- No significant increase in thrombotic risk following the widespread adoption of TPO-RAs in ITP: A comparative study.Global medical genetics · 2026Article
- Repurposing Hetrombopag for Multiple Myeloma by Targeting PNPO: A Celastrol-Inspired Approach.Basic & clinical pharmacology & toxicology · 2026Article
- From Hemolysis to Lupus: A Case of Evans Syndrome Revealing Systemic Autoimmunity.Clinical case reports · 2026Article
- [Construction and evaluation of a thrombosis risk prediction model in patients with primary immune thrombocytopenia].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2026Article
- Avatrombopag in heavily pretreated chronic immune thrombocytopenia: a single center experience from Oman.Frontiers in medicine · 2026Article
- Efficacy and Safety of Avatrombopag Treatment in Immune Thrombocytopenia Patients in Poland: A Multicenter Study.TH open : companion journal to thrombosis and haemostasis · 2026Article
- Thromboembolic adverse events associated with TPO-RA in ITP treatment: a pharmacovigilance analysis of the FDA Adverse Event Reporting System.Frontiers in immunology · 2026Article
- Beyond platelet counts: assessing safety of postsplenectomy TPO-RA use in ITP.Blood advances · 2025Article
- Article
- Prevalence and characteristics of acute ischemic stroke and intracranial hemorrhage in patients with immune thrombocytopenic purpura and immune thrombotic thrombocytopenic purpura: a systematic review and meta-analysis.Neurological research and practice · 2025Article
- Hetrombopag treatment for immune thrombocytopenia in pregnancy refractory to corticosteroids and intravenous immunoglobulin: a case report.Frontiers in medicine · 2025Article
- Insights on treatment of adult ITP: algorithm for management and role of multimodal therapy.Hematology. American Society of Hematology. Education Program · 2024Review
- The Many Faces of Immune Thrombocytopenia: Mechanisms, Therapies, and Clinical Challenges in Oncological Patients.Journal of clinical medicine · 2024Review
- Avatrombopag and Platelet Recovery in Sepsis-Associated Thrombocytopenia: A Retrospective Observational Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
- Analysis of Risk Factors and the Establishment of a Predictive Model for Thrombosis in Patients with Immune Thrombocytopenia.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thrombopoietin receptor agonists (TPO-RAs) have a role in second-line immune thrombocytopenic purpura (ITP) treatment, binding to and activating thrombopoietin receptors on megakaryocyte membranes in the bone marrow. This promotes megakaryocyte maturation and increases platelet production. Despite a 2-6% incidence of thrombotic events during TPO-RA treatment, it remains uncertain whether TPO-RAs elevate thrombosis rates. A comprehensive search of electronic databases was conducted using the relevant search criteria. To assess the risk of bias, the included studies were assessed using the revised Cochrane Risk of Bias Assessment Tool 2.0, and a meta-analysis was performed using RevMan 5.4.1. A total of 1,698 patients with ITP were included from randomized controlled trials (RCTs). There were 26 thromboembolic events in the TPO-RAs group and 4 in the control group. However, there was no significant difference in the incidence of thrombotic events between the two groups [odds ratio (OR)=1.76, 95% confidence interval (CI): 0.78-4.00, P=0.18], even if the duration of treatment was >12 weeks (OR=2.46, 95% CI: 0.81-7.43, P=0.11). Subgroup analysis showed that none of the four drugs significantly increased the incidence of thrombotic events (romiplostim: OR=0.92, 95% CI: 0.14-6.13, P=0.93; eltrombopag: OR=2.32, 95% CI: 0.64-8.47, P=0.20; avatrombopag: OR=4.15, 95% CI: 0.20-85.23, P=0.36; and hetrombopag: OR=0.76, 95% CI: 0.03-18.76, P=0.87). There was also no significant difference in the results of the double-blinded placebo-controlled RCTs (OR=1.21, 95% CI: 0.41-3.58, P=0.73). Compared to patients with ITP who did not receive TPO-RA treatment, those receiving TPO-RA treatment did not exhibit a significantly increased risk of thrombotic events.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.