Efficacy and safety of thrombopoietin receptor agonists in modern treatment of immune thrombocytopenia

Abstract

Immune thrombocytopenia (IT), characterized by isolated platelet decrease and bleeding, could be primary or secondary to infections, autoimmune diseases, drugs. Classical treatments for IT are corticosteroids, immunoglobulins (1st line) and splenectomy, immunosuppression (2nd line), therapies based on decreasing platelets’ destruction. Thrombopoietin receptor agonists (TRA), romiplostim, eltrombopag and avatrombopag, modern drugs used for refractory patients, increase platelets production. The aim of the article is a review of literature based on 59 scientific articles regarding the efficacy and safety of TRA in primary IT. This review is helpful to specialists, given the limited experience with these drugs, approved in 2008 in the United States and in 2009 in Europe. TRA have shown good efficacy, treatment leading to increased platelet counts, decreased haemorrhagic episodes, reduced concomitant medication. TRA were well tolerated, the adverse effects reported were medullary fibrosis, thrombosis, headache, rhinopharyngitis, hepatocitolysis, fatigue.