AUTHOR=Meng Fanqiao , Chen Xiuqiong , Yu Shunjie , Ren Xiaotong , Liu Zhaoyun , Fu Rong , Li Lijuan 

TITLE=Safety and Efficacy of Eltrombopag and Romiplostim in Myelodysplastic Syndromes: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Oncology

VOLUME=Volume 10 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.582686

DOI=10.3389/fonc.2020.582686

ISSN=2234-943X

ABSTRACT=Background and Aim: Many studies indicated that eltrombopag and romiplostim
could improve hematopoietic function in patients with myelodysplastic syndromes
(MDS), but their toxicity and efficacy were not known. This meta-analysis aimed to
investigate the safety and efficacy of eltrombopag and romiplostim in MDS.
Methods:A full-scale search strategy was used to search relevant published studies in
PubMed, Embase, Web of Science, and the Cochrane Library until January 2019
using a random-effects model and the pooled risk ratio (RR) with 95% confidence
interval (CI) as the effect indicator. Statistical analyses were performed using RevMan
5.3.
Results:This meta-analysis included 8 studies comprising 1047 patients. A lower RR
of overall response rate (ORR) (RR: 0.65; 95% CI, 0.47–0.9) and grade ≥3 bleeding
events (RR: 0.36; 95% CI, 0.36–0.92) were observed after romiplostim and
eltrombopag treatment compared with placebo. No difference in mortality, serious
adverse events, platelet transfusion, hematologic improvement (HI), and AML
transformation was observed.
Conclusions:Thrombopoietin receptor agonists (TPO-RAs) romiplostim and
eltrombopag were effective in reducing bleeding events, especially grade ≥3 bleeding
events. However, it might reduce the ORR of MDS. Due to the limited treatment of
MDS and the poor response to the drug, this may be a selection method for MDScombined with fatal bleeding, although further research is needed to confirm the
effectiveness of this approach.