Abstract
Background
Treatment of thrombocytopenia with thrombopoietin receptor agonists (TPORAs) seems
to be associated with portal vein thrombosis (PVT) in patients with chronic liver
disease (CLD). We performed a meta-analysis of the trials carried out in this clinical
setting to assess if such association is detectable.
Methods
We performed a meta-analysis with studies that compared the effect of TPORAS vs placebo
in patients with CLD and thrombocytopenia.
Results
Four studies, including 1953 patients, reported the incidence of PVT in patients with
CLD and thrombocytopenia treated with TPORAs or placebo. No significant difference
was found for incidence of PVT in patients treated with TPORAs compared with placebo
(O.R.: 2.8; 95% C.I., 0.97–8.16; p = 0.055). A significant association between PVT
and TPORAs was observed only in patients treated with eltrombopag (O.R.: 3.8; 95%
C.I., 1.14–13.2; p = 0.03). Three studies, including 514 patients who were undergoing
an elective invasive procedure, analyzed the incidence of PVT in TPORAs—treated patients
with CLD and thrombocytopenia; no significant difference was found for incidence of
PVT in patients treated with TPORAs compared with placebo (O.R.: 2.6; 95% C.I., 0.6–11.6;
p = 0.212). A significant difference was found for incidence of arterial and venous
thrombo-embolic events in CLD patients treated with eltrombopag compared with placebo-treated
patients (O.R.: 3.4; 95% C.I., 1.5–7.7; p = 0.003).
Conclusion
The results of this meta-analysis show that TPORAs are not associated with PVT in
CLD patients even in the case of surgical procedure. PVT risk seems to be associated
only with eltrombopag use.
Keywords
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Article info
Publication history
Published online: June 20, 2018
Accepted:
June 8,
2018
Received:
May 20,
2018
Identification
Copyright
© 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
