Ann Hematol: Comparison of the efficacy of 19 drug therapies in patients with idiopathic thrombocytopenic purpura

Immune thrombocytopenia (ITP) is the most common clinical bleeding disease, with high mortality and poor long-term quality of life in severe patients
.
There are various treatment options, but there is still controversy about how to choose the appropriate treatment method

.

Immune thrombocytopenia (ITP) is the most common clinical bleeding disease, with high mortality and poor long-term quality of life in severe patients

Figure 1: Study selection process: 19 RCTs corresponding to 45 groups included in this multi-treatment meta-analysis

Figure 1: Study selection process: 19 RCTs corresponding to 45 groups included in this multi-treatment meta-analysis

These studies compared multiple drugs or their combinations in therapeutic dose ranges for the treatment of ITP
.
The primary endpoint was based on the proportion of patients who responded to these therapies

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These studies compared multiple drugs or their combinations in therapeutic dose ranges for the treatment of ITP

Figure 2: Multi-treatment treatment (response rate) meta-analysis comparing networks

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Figure 2: Multi-treatment treatment (response rate) meta-analysis comparing networks

Figure 3: Efficacy of 19 ITP treatments in alphabetical order
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A = placebo

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Figure 3: Efficacy of 19 ITP treatments in alphabetical order
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The efficacy of eltrombopag plus rituximab, avatrombopag, dexamethasone plus anti-HP, and dexamethasone plus rhTPO was significantly higher than that of placebo (OR46.
66, 29.
44, 2.
66, 1.
86) Or dexamethasone alone (OR46.
22, 29.
01, 2.
22, 1.
40)
.

Figure 4: Efcacy ranking

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Figure 4: Efcacy ranking
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The inferred endpoints used were not necessarily the same between studies, which was the main source of heterogeneity in this meta-analysis
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At the same time, this may create a certain amount of heterogeneity due to the incomplete agreement of the articles included in the meta-analysis from the included populations
.
Future face-to-face clinical trials still need better validation
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Overall, placebo, oral immunosuppressants, and dexamethasone plus oseltamivir were less effective than other tested ITP therapies
.
Eltrombopag plus rituximab may be the best option when starting treatment for ITP
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Overall, placebo, oral immunosuppressants, and dexamethasone plus oseltamivir were less effective than other tested ITP therapies
.
Eltrombopag plus rituximab may be the best option when starting treatment for ITP
.

 

Original source:

Original source:

Zhou, H.
, Fan, J.
, He, J.
  et al.
 Comparative efficacy of 19 drug therapies for patients with idiopathic thrombocytopenic purpura: a multiple-treatments network meta-analysis.
  Ann Hematol (2022).
https://doi .
org/10.
1007/s00277-022-04784-0.

Zhou, H.
, Fan, J.
, He, J.
  et al.
 Comparative efficacy of 19 drug therapies for patients with idiopathic thrombocytopenic purpura: a multiple-treatments network meta-analysis.
  Ann Hematol (2022).
https://doi .
org/10.
1007/s00277-022-04784-0.
Zhou, H.
, Fan, J.
, He, J.
  et al.
 Comparative efficacy of 19 drug therapies for patients with idiopathic thrombocytopenic purpura: a multiple-treatments network meta- analysis.
  Ann Hematol (2022).
https://doi.
org/10.
1007/s00277-022-04784-0.
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