Eltrombopag 12.5mg tablets

ObjectiveThe objective of this study was to compare and rank the efficacy and safety of different thrombopoietin receptor agonists (TPO-RAs) in the treatment of chemotherapy-induced thrombocytopenia (CIT) among patients with solid tumors.MethodsPubMed, Cochrane Library, Embase, MEDLINE, Web of Science, ClinicalTrials.gov, CNKI, Wanfang Database, VIP Database, SinoMed, and China Drug Trials (www.chinadrugtrials.org.cn) were searched for randomized controlled trials (RCTs) of TPO-RAs for CIT in solid tumors from the inception to 31 December 2024. The Cochrane Risk of Bias Assessment Tool 2 was used for assessing the risk of bias. We performed a random-effects network meta-analysis using STATA 14.0 software. Treatments were ranked according to the surface under the cumulative ranking curve. Confidence of the evidence was assessed using Confidence in Network Meta-Analysis. The study protocol was registered with PROSPERO (number CRD42024612536).ResultsA total of eight studies (568 patients) were included. Most RCTs (7/8) showed a low risk of bias. The confidence in evidence was often low or very low. Our network meta-analysis indicates that when compared with placebo, hetrombopag (summary RR 0.45, 95% confidence interval 0.28-0.73) and eltrombopag (0.57, 0.41-0.81) significantly reduced the incidence of chemotherapy dose reduction or delay due to thrombocytopenia. Hetrombopag (0.29, 0.13-0.68) also significantly reduced the platelet transfusions. Eltrombopag had the lowest risk for bleeding event (0.41, 0.13-1.23) and mortality (0.83, 0.48-1.44). There were no significant differences in the risk of adverse events (AEs) between interventions. Hetrombopag (0.37, 0.02-8.68) showed the least risk of thrombosis. According to rankograms, hetrombopag was ranked as the best for reducing the incidence of chemotherapy dose reduction or delay, and platelet transfusions, with the least risk of serious AEs and thrombosis. Eltrombopag carried the least risk of bleeding events and mortality.ConclusionOur network meta-analysis suggested that based on the limited indirect data, hetrombopag may represent the preferred therapy for avoiding chemotherapy dose reductions or delays and platelet transfusion. Eltrombopag may be considered the preferred therapeutic option for avoiding bleeding events and mortality. Both compounds have acceptable safety profiles. However, larger head-to-head trials are needed to confirm these findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024612536, identfier CRD42024612536.

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BackgroundThe comparative efficacy of pharmacological treatments for lower-risk myelodysplastic syndromes (LR-MDS) remains uncertain because head-to-head randomised evidence is limited.MethodsWe performed a systematic review and network meta-analysis of randomised controlled trials evaluating pharmacological treatments for LR-MDS. Outcomes of interest were haematological improvement-erythroid (HI-E), red blood cell transfusion independence (RBC-TI), haematological improvement-platelet (HI-P), and adverse events (AEs).ResultsWe included 20 trials (2,877 participants), of which 17 trials (2,670 participants) contributed to connected treatment networks. For HI-E, luspatercept and ESA-based regimens were associated with higher rates. Lenalidomide-containing regimens showed favourable RBC-TI outcomes, including lenalidomide plus ESA, lenalidomide with or without ESA and/or G-CSF, and lenalidomide monotherapy. For HI-P, eltrombopag and romiplostim showed potential benefits. Safety profiles differed across treatments: CC-486 and imetelstat were associated with higher odds of neutropenia and gastrointestinal toxicity, whereas luspatercept was associated with increased fatigue and AEs.ConclusionComparative treatment benefit in LR-MDS differs by clinical endpoint. These findings support an individualised, goal-directed treatment approach rather than a single universally superior therapy.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251184384.

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BackgroundAplastic anemia (AA) is a bone marrow failure syndrome. Whether the combination of TPO-RAs and IST is superior to IST alone is an ongoing debate. This meta-analysis compares the efficacy of EPAG+IST versus IST alone, and assesses the initiation timing and treatment duration of eltrombopag (EPAG) across different age groups of AA patients.MethodsThe literature was retrieved from Chinese and English databases up to October 1, 2025. The analysis was conducted using RevMan 5.4 software, employing a fixed-effects model to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the outcomes. The I² statistic was used to assess heterogeneity among included studies.Results21 studies involving 2,239 patients were included. The overall response rate in the EPAG+IST group was higher at 3 months (OR = 2.13, 95% CI 1.65 - 2.74, P ConclusionThe addition of EPAG to IST may improve early hematological responses at 3 and 6 months in patients with AA, with no significant difference at 12 months. Concurrent initiation (within 7 days) was associated with earlier responses in adults.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024604778.

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