Effects of oral non-peptidic thrombopoietin receptor agonists on hepatic enzyme in adult patients with immune thrombocytopenia：a meta-analysis
- VernacularTitle:口服非肽类促血小板生成素受体激动剂对成年免疫性血小板减少症患者肝酶影响的Meta分析
- Author:
Tiantian LU
1
;
Nan SHEN
1
;
Suyue ZHU
1
;
Jingjing YAN
1
Author Information
1. Dept. of Pediatrics，the Affiliated Suqian Hospital of Xuzhou Medical University，Jiangsu Suqian 223800，China
- Publication Type:Journal Article
- Keywords:
non-peptidic thrombopoietin receptor agonists;
thrombocytopenia;
hepatic enzyme;
eltrombopag;
avatrombopag
- From:
China Pharmacy
2026;37(4):510-515
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the effects of oral non-peptidic thrombopoietin receptor agonists （TPO-RAs） on hepatic enzyme in adult patients with immune thrombocytopenia. METHODS A comprehensive literature search was conducted in PubMed， Web of Science， CNKI， Wanfang database and the Chinese Medical Association Journal Full-Text Database to collect randomized controlled trials （RCTs） comparing oral non-peptidic TPO-RAs （intervention group） with placebo or conventional therapy （control group）. All databases were searched from their inception to June 2025. After literature screening， data extraction and quality assessment of the included studies， meta-analysis was conducted using RevMan 5.4.1 software. RESULTS Twelve RCTs comprising 1 388 patients were included， with 971 in the intervention group and 417 in the control group. Meta-analysis results showed that there were no significant differences between the two groups in terms of the incidence of hepatic enzyme elevation[OR＝1.24， 95%CI （0.77， 1.99）， P ＝0.37 ] ， the incidence of hepatic enzyme elevation in patients treated for ≥6 weeks[OR＝1.21， 95%CI （0.73， 1.99）， P ＝0.46 ] ， and the incidence of severe hepatic enzyme elevation[OR＝1.39， 95%CI（0.46， 4.20）， P ＝0.55 ] . Subgroup analysis showed that there were no significant differences in the incidence of hepatic enzyme elevation between the intervention group and control group among patients using eltrombopag[OR＝1.57，95%CI（0.85，2.87）， P ＝0.15 ] ， avatrombopag[OR＝0.88，95%CI （0.09，8.46）， P ＝0.91 ] ， and hetrombopag[OR＝1.04，95%CI（0.30，3.65）， P ＝0.95 ] ， respectively. CONCLUSIONS Oral non-peptidic TPO-RAs do not significantly increase the risk of hepatic enzyme elevation in adult patients with immune thrombocytopenia， and show an overall favorable hepatic safety profile.
