Efficacy and safety of thrombopoietin receptor agonists in patients with primary immune thrombocytopenia: A systematic review and meta-analysis.
Efficacy and safety of thrombopoietin receptor agonists in patients with primary immune thrombocytopenia: A systematic review and meta-analysis.
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血小板生成素受体激动剂对原发性免疫性血小板减少症患者的疗效和安全性：系统评价和荟萃分析
DOI：
10.1038/srep39003
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发表时间：
2016-12-19
影响因子：
4.6
通讯作者：
Gao CJ
中科院分区：
文献类型：
--
作者：
Wang L;Gao Z;Chen XP;Zhang HY;Yang N;Wang FY;Guan LX;Gu ZY;Zhao SS;Luo L;Wei HP;Gao CJ
免疫性血小板减少症（ITP）是一种自身免疫性疾病，其特征是血小板破坏增加和血小板生成受损。在这项研究中，我们进行了一项系统的审查和荟萃分析，以确定血小板生成素受体激动剂（TPO-RAs）在原发性ITP患者的疗效和安全性。本研究纳入了13项随机对照试验，其汇总结果表明TPO-RA显著增加血小板应答（R）和持久应答（DR）率[风险比（RR）：2.77，95%置信区间（CI）：2.01- 3.82，P = 5.9 × 10−10; RR：7.52，95% CI：3.94- 14.35，P = 9.2 × 10−10;分别]和TPO-RA显著降低任何或严重出血事件的发生率（RR：0.80，95%CI：0.67- 0.95，P = 0.013; RR：0.52，95%CI：0.27- 0.99，P = 0.048;分别）。此外，我们的研究结果表明，与对照组相比，TPO-RA组需要急救药物的患者比例显著降低（RR：0.50，95%CI：0.42- 0.59，P = 2.0 × 10 - 15），TPO-RA和对照方案之间任何或严重不良事件的发生率相似（RR：1.01，95% CI：0.92-1.10; RR：0.74，95% CI：0.54-1.01）。这些结果表明，TPO-RA是原发性ITP患者的有效和安全的二线治疗选择。
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased platelet destruction and impaired platelet production. In this study, we conducted a systematic review and meta-analysis to determine the efficacy and safety of thrombopoietin receptor agonists (TPO-RAs) in primary ITP patients. Thirteen randomized controlled trials were included in this study, the pooled results of which demonstrated that TPO-RAs significantly increased platelet response (R) and durable response (DR) rates [risk ratio (RR): 2.77, 95% confidence interval (CI): 2.01–3.82,P= 5.9 × 10−10; RR: 7.52, 95% CI: 3.94–14.35,P= 9.2 × 10−10; respectively] and that TPO-RAs significantly reduced the incidences of any or severe bleeding events (RR: 0.80, 95% CI: 0.67–0.95,P= 0.013; RR: 0.52, 95% CI: 0.27–0.99,P= 0.048; respectively). Moreover, our results indicated that there was a significant reduction in the proportion of patients needing rescue medications in the TPO-RA groups compared with the control groups (RR: 0.50, 95% CI: 0.42–0.59,P= 2.0 × 10−15) and that the rates of any or severe adverse events were similar between the TPO-RA and control regimens (RR: 1.01, 95% CI: 0.92–1.10; RR: 0.74, 95% CI: 0.54–1.01; respectively). These findings demonstrate that TPO-RAs are an effective and safe second-line treatment option for primary ITP patients.
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影响因子：
158.5
作者：
Kuter, David J.;Rummel, Mathias;Berger, Dietmar P.
通讯作者：
Berger, Dietmar P.
影响因子：
20.3
作者：
Portielje, JEA;Westendorp, RGJ;Brand, A
通讯作者：
Brand, A
影响因子：
5.1
作者：
Buchanan, GR;Adix, L
通讯作者：
Adix, L
影响因子：
20.3
作者：
Bussel, James B.;Buchanan, George R.;Jun, Susie
通讯作者：
Jun, Susie
影响因子：
20.3
作者：
Rodeghiero, Francesco;Stasi, Roberto;George, James N.
通讯作者：
George, James N.