A Systematic Review Of Recombinant Human Thrombopoietin For The Treatment Of Immune Thrombocytopenia

Objective:To systematically review the clinical effectiveness and safety of recombinant human thrombopoietin(rhTPO) in treating Immune thrombocytopenia(ITP).Method: Database such as PubMed,the Cochrane Libaray,CBM, CNKI,Wangfang Data were searched to collect randomized controlled trials(RCT)involving the effectiveness and safety of rhTPO for ITP from the date of their establishment to November 2014. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies.Then Meta-analysis was performed using RevMan 5.2software.Results: Five RCTs involving 192 patients were included.The patients of trial group were treated with rhTPO and glucocorticoid, the control group were treated with glucocorticoid alone.The results of Meta-analyses show that the trial group is superior to the control group in the aspects of effectiveness rate [OR=2.1625,95%CI(1.06,4.38),P=0.03],the significant effectiveness rate [OR=3.25, 95%CI(1.26,8.39), P=0.01];In the time of platelet starting to rise[WMD=-4.00, 95%CI(-4.66,-3.16), P<0.00001],up to 50x109/L for platelet[WMD=-5.25,95%CI(-6.31,-4.18),P<0.00001] and in the peak time of platelet[WMD=-9.99, 95%CI(-15.27,-4.70),P=0.00002],the trial group is better than the control group; There are no significant difference between the two groups in the hyeperglycemia,[OR=0.43,95%CI(0.10, 1.85), P=0.26],hypertension[OR=0.73,95%CI(0.18,2.97), P=0.66].Conclusion: RhTPO combined with glucocorticoid can improve the effectiveness rate and significant effectiveness rate in the treatment of ITP, And it can shorten the time of platelet starting to rise, and up to 50x109/L,so do the peak of platelet count; The incidience rate of hyeperglycemia and hypertension between thetwo groups is similiar without statistically significant difference. However,because of limited quantity and quality of the included studies,the above conclusion needs to be further verified by conducting more high-quality studies.