Chronic idiopathic thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterized by low platelet counts. To date, the therapies that primarily aim to reduce platelet destruction, such as corticosteroids, intravenous immunoglobulins and splenectomy, have been the mainstay of treatment in ITP. However, TPO receptor agonists such as romiplostim and eltrombopag, which aim to enhance platelet production, are novel drugs that have been suggested to be more effective. This review included six trials with 808 patients and compared TPO receptor agonists with placebo or standard of care (SOC).
None of the studies included overall survival, therefore we could not confirm whether TPO receptor agonists help to prolong life. There is uncertainty as to whether TPO receptor agonists reduce the risk of significant bleeding events in chronic ITP. This review confirms the greater platelet response by using TPO receptor agonists. Adverse effects of TPO receptor agonists were similar to that of placebo and SOC. More research is needed to explore the role of TPO receptor agonists in the treatment of chronic ITP more fully.