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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pharmacol. | doi: 10.3389/fphar.2019.00829

Efficacy and safety of avatrombopag in patients with thrombocytopenia: a systematic review and meta-analysis of randomized controlled trials

  • 1Chengdu University of Traditional Chinese Medicine, China
  • 2Southwest Medical University, China
  • 3southwest medical university, China

Background: Avatrombopag is a novel oral, nonpeptide thrombopoietin receptor agonist (TPO-RA). A few studies have shown that avatrombopag is effective against thrombocytopenia. However, no systematic review has been conducted on the efficacy and safety of avatrombopag. Therefore, the aim of this study was to comprehensively assess the efficacy and safety of avatrombopag patients with thrombocytopenia.
Methods: Databases including Medline, PubMed, Embase, the Cochrane Library and ClinicalTrials.gov were searched for randomized controlled trials that compared avatrombopag with placebo in patients with thrombocytopenia. The deadline was March 2019.
Results: In total, 743 patients were analyzed in five clinical trials. Patients treated with avatrombopag achieved higher platelet response (OR: 17.71, 95% CI [11.01 to 28.48], p < 0.00001) than with placebo. Avatrombopag produced an absolute increment in platelet count (WMD: 31.13%, 95% CI [22.27 to 39.99], p < 0.00001) unlike the placebo. In addition, the incidence of serious adverse events (RR: 1.18, 95% CI [0.72 to 1.93], p = 0.51) and deaths (RR: 0.93, 95% CI [0.19 to 4.45], p = 0.93) in patients treated with avatrombopag were not significantly different from that in patients treated with placebo. The incidence of adverse events in patients treated with avatrombopag was slightly higher than that in patients treated with placebo (RR: 1.25, 95% CI [1.05 to 1.49], p = 0. 01) after one trial with high heterogeneity was removed.
Conclusions: This meta-analysis showed that avatrombopag was an effective treatment for thrombocytopenia, but there is sufficient evidences to indicate that adverse events may occur.

Keywords: Avatrombopag, Thrombocytopenia, TPO, Thrombopoietin receptor agonist, Platelet, Systematic review

Received: 10 Apr 2019; Accepted: 27 Jun 2019.

Edited by:

Tahir M. Khan, Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Pakistan

Reviewed by:

Robert L. Lins, Independent researcher
Raja A. Aftab, School of Pharmacy, Taylor's University, Malaysia  

Copyright: © 2019 Li, Li, Huang, Yang, Guo, Wang, Lian, Zou and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Wenjun Zou, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan Province, China, zouwenjun@163.com
Prof. Jianming Wu, Southwest Medical University, Luzhou, Sichuan, China, jianmingwu@swmu.edu.cn