Selected studies of thrombopoietin receptor agonist use in pregnancy
| Study . | Medications . | Design . | Population . | Weeks of TPO-RA exposure during pregnancy . | Outcomes . | Adverse events . |
|---|---|---|---|---|---|---|
| Kong et al34 | Recombinant human thrombopoetin (rhTPO) | Multicenter single-arm open-label prospective study (China) | N = 31, pregnant patients with platelet count less than 30 × 109/L despite IVIG/corticosteroids* | 2 weeks of once-daily rhTPO followed by maintenance dosing tapered to every other day when platelets exceeded 50 × 109/L and discontinued at 100 × 109/L | Response: platelet count >30 × 109/L (and at least 2 × baseline) on day 14 achieved in 74.2% (24/31) Complete response: platelet count >100 × 109/L achieved in 32% (10/31) | Maternal: Dizziness (1) Fatigue (1) Pain at injection site (1) Neonate: Thrombocytopenia (9) Abdominal distention (1) |
| Michel et al35 | Eltrombopag or romiplostim | Multicenter observational study (international) | N = 15 women, 17 pregnancies, pregnant patients with diagnosis of either primary or secondary ITP treated with TPO-RA for at least 1 week during pregnancy | Median 4.4 weeks (range, 1-39 weeks) | Response: platelet count >30 × 109/L (and at least 2 × baseline) achieved in 66% (10/15) Complete response: platelet count >100 × 109/L and absence of bleeding achieved in 40% (6/15) | Maternal: Headaches (2) Neonate: Preterm delivery (5) Thrombocytopenia (6) Death (trisomy 8) (1)† Pulmonary artery stenosis (1) Grade 1 intraventricular hemorrhage (1)† |
| Study . | Medications . | Design . | Population . | Weeks of TPO-RA exposure during pregnancy . | Outcomes . | Adverse events . |
|---|---|---|---|---|---|---|
| Kong et al34 | Recombinant human thrombopoetin (rhTPO) | Multicenter single-arm open-label prospective study (China) | N = 31, pregnant patients with platelet count less than 30 × 109/L despite IVIG/corticosteroids* | 2 weeks of once-daily rhTPO followed by maintenance dosing tapered to every other day when platelets exceeded 50 × 109/L and discontinued at 100 × 109/L | Response: platelet count >30 × 109/L (and at least 2 × baseline) on day 14 achieved in 74.2% (24/31) Complete response: platelet count >100 × 109/L achieved in 32% (10/31) | Maternal: Dizziness (1) Fatigue (1) Pain at injection site (1) Neonate: Thrombocytopenia (9) Abdominal distention (1) |
| Michel et al35 | Eltrombopag or romiplostim | Multicenter observational study (international) | N = 15 women, 17 pregnancies, pregnant patients with diagnosis of either primary or secondary ITP treated with TPO-RA for at least 1 week during pregnancy | Median 4.4 weeks (range, 1-39 weeks) | Response: platelet count >30 × 109/L (and at least 2 × baseline) achieved in 66% (10/15) Complete response: platelet count >100 × 109/L and absence of bleeding achieved in 40% (6/15) | Maternal: Headaches (2) Neonate: Preterm delivery (5) Thrombocytopenia (6) Death (trisomy 8) (1)† Pulmonary artery stenosis (1) Grade 1 intraventricular hemorrhage (1)† |