Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane on Use of TPO-RAs to Prevent, Treat CIT

Cochrane; 2017 Nov 27; Zhang, Chuai, Nie, et al

Evidence does not support the use of thrombopoietin receptor agonists (TPO-RAs) to prevent chemotherapy-induced thrombocytopenia (CIT) or its recurrence in patients with solid tumors, according to a Cochrane review of 6 trials involving 268 individuals.

When patients with normal platelet count before chemotherapy are given eltrombopag vs placebo to prevent CIT:

  • TPO-RAs may have little or no difference to the all-cause mortality (based on low-quality of evidence).
  • There is not enough evidence to determine whether TPO-RAs reduce the number of patients with any or severe bleeding episodes (very low quality of evidence).

When patients with low platelet counts during a chemotherapy cycle are given romiplostim vs placebo to prevent CIT recurrence, there is not enough evidence to determine whether TPO-RAs reduce the number of patients with any or severe bleeding episodes (very low quality of evidence).

Citation:

Zhang X, Chuai Y, Nie W, Wang A, Dai G. Thrombopoietin receptor agonists for prevention and treatment of chemotherapy-induced thrombocytopenia in patients with solid tumors. Cochrane Database of Syst Rev. 2017, Issue 11. Art. No.: CD012035. doi:10.1002/14651858.CD012035.pub2.

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