Thrombopoietin Receptor Agonists in Primary Immune Thrombocytopenia

Overview

Journal Semin Hematol

Specialty Hematology

Date 2013 May 14

PMID 23664510

Citations 17

Authors

Deborah Siegal

Mark Crowther

Adam Cuker

Affiliations

Soon will be listed here.

Abstract

Thrombopoietin (TPO) regulates thrombopoiesis through activation of TPO receptors on the megakaryocyte cell surface, resulting in increased platelet production. The TPO receptor agonists are novel treatments for patients with chronic ITP aimed at increasing platelet production through interactions with the TPO receptor on megakaryocytes. Two TPO receptor agonists, romiplostim and eltrombopag, have received regulatory approval. In patients with chronic ITP who remain at risk of bleeding following treatment with first-line therapies, these agents have been shown to increase platelet counts, decrease bleeding events, and reduce the need for adjunctive or rescue treatments. The TPO receptor agonists are well-tolerated, though uncertainty remains regarding the risk of thromboembolism and bone marrow fibrosis. Comparative clinical trial data addressing the efficacy, safety, cost-effectiveness, and impact on health-related quality of life of TPO receptor agonists relative to other second-line treatment options are needed to guide treatment decisions in chronic ITP patients who fail first-line therapies.

Citing Articles

Current knowledge of thrombocytopenia in sepsis and COVID-19.

Cheng J, Zeng H, Chen H, Fan L, Xu C, Huang H Front Immunol. 2023; 14:1213510.

PMID: 37841241 PMC: 10568455. DOI: 10.3389/fimmu.2023.1213510.

Eltrombopag for Adults and Children with Immune-Refractory Thrombocytopenic Purpura: A Systematic Review.

Torelli D, Soares Oliveira C, Nai G, Trindade E, Prestes-Carneiro L J Clin Med. 2023; 12(12).

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Early initiation of second-line therapy in primary immune thrombocytopenia: insights from real-world evidence.

Cuker A, Buckley B, Mousseau M, Barve A, Haenig J, Bussel J Ann Hematol. 2023; 102(8):2051-2058.

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Severe Thrombocytopenia in a 30-Year-Old African American Male With Newly Diagnosed Sarcoidosis: A Case Report.

Pasli M, Lovell K, Vulasala S, Hairr M, Bandaru R, Khalilullah M Cureus. 2023; 15(1):e34135.

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Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity.

Delshad M, Safaroghli-Azar A, Pourbagheri-Sigaroodi A, Poopak B, Shokouhi S, Bashash D Int Immunopharmacol. 2021; 99:107995.

PMID: 34304001 PMC: 8295197. DOI: 10.1016/j.intimp.2021.107995.

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