2018
DOI: 10.1038/s41598-017-19099-8 View full text |Buy / Rent full text
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Abstract: In absence of direct comparison, we conducted an indirect-comparison meta-analysis to evaluate the efficacy and safety of thrombopoietin-receptor agonists(TPO-RAs) in treatment of pediatric persistent or chronic immune thrombocytopenia(ITP). PubMed, Embase, Cochrane Library, Clinical Trials.gov, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database were searched from their earliest records to May 2017. Randomized controlled trials comparing the TPO-RAs with placebo in pediatric IT… Show more

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“…On assessment of the other primary endpoint of sustainable platelet response, the overall results were numerically in favor of TPO‐RAs versus RTX, but there was great discrepancy between eltrombopag (0.38–0.81) and romiplotism (0.52–0.97). These results contrast with another systematic review comparing eltrombopag to romiplostim in pediatric ITP, which found a similar sustainable platelet response with both agents 45 . It is important to note that the duration of follow‐up and definition of sustainability is not consistent across the studies, and one of the possible reasons of the great discrepancy in the sustainability of the platelet response between RTX and other agents could be that SPR definition in RTX studies (reaching up to 36 months) were much longer than TPO‐RAs.…”
Section: Discussioncontrasting
“…No differences were reported in response or sustainability of response between both types of TPO-RAs (eltrombopag and romiplostim). Our results are consistent with those of a systemic review analyzing five randomized controlled trials studying the efficacy and safety of eltrombopag and romiplostim in children with persistent and chronic ITP, and no difference was noted between the two types [22]. Although both TPO-RAs showed good initial response, approximately one-third of our children lost their response to each type of TPO-RA.…”
Section: Figuresupporting
“…12 Indirect treatment comparisons found no significant difference in safety and efficacy of the 2 drugs. [13][14][15] Given this, assuming clinical equivalence may be a reasonable, and useful, simplifying assumption. Cost-minimization models are an appropriate design under that assumption, specifically when "two therapies embody a near-identical technology (eg, drugs of the same pharmacological class)."…”
Section: What This Study Addsmentioning