Abstract
Background and Objectives
Eltrombopag seems to be effective in treating patients with aplastic anemia in several clinical trials. This paper aims to perform the first meta-analysis analyzing the efficacy and safety of eltrombopag for aplastic anemia.
Methods
Literatures were retrieved from PubMed, EMBASE, OVID, Web of Science, Cochrane, Wanfang, http://clinicaltrials.gov and World Health Organization International Clinical Trials Registry Platform search portal from establishment to July 2018. Using Stata statistical software version 12.0, subgroup analyses and sensitivity analyses were conducted.
Results
The overall hematologic response rate is 88% (95% CI 83–94%) for patients treated with eltrombopag plus immunosuppressive therapy, and 47% (95% CI 38–56%) for patients with refractory aplastic anemia using eltrombopag alone. Karyotype abnormality rates include an overall rate of 10% (95% CI 7–14%), a subtotal rate of 8% (95% CI 3–13%) for patients who are treated with eltrombopag plus immunosuppressive therapy without using antithymocyte globulin before, and a subtotal rate of 17% (95% CI 10–24%) for patients with refractory aplastic anemia treated with eltrombopag alone.
Conclusions
With different treatments and in different conditions eltrombopag showed a distinctive effect for aplastic anemia. However, clone evolution and adverse events were associated with treatment.
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This work was supported by Youth Project of National Natural Science Foundation (Grant no. 81200400), top-notch innovative talents project and Fujian project (Grants 2016Y9025 & 2016J06018 & 2017I0004); Fujian Medical University teaching reform project (Y17005) and Fujian Provincial Health and Family planning Commission Youth Research Project (2017-1-6).
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Yaqun Hong, Xiaofan Li, Bo Wan, Nainong Li, and Yuanzhong Chen declare that they have no conflict of interest.
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Hong, Y., Li, X., Wan, B. et al. Efficacy and Safety of Eltrombopag for Aplastic Anemia: A Systematic Review and Meta-analysis. Clin Drug Investig 39, 141–156 (2019). https://doi.org/10.1007/s40261-018-0725-2
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DOI: https://doi.org/10.1007/s40261-018-0725-2