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No link between thrombopoietin receptor agonists use and portal vein thrombosis in CLD

4 days ago

Thrombopoietin receptor agonists (TPORAs) show no clear association with portal vein thrombosis (PVT) when used to treat patients with chronic liver disease (CLD), reports a recent meta-analysis.

A pooled analysis of four studies (n=1,953 CLD patients) showed that there was no significant increase in the incidence of PVT in patients treated with TPORAs compared with those who received placebo (odds ratio [OR], 2.8; 95 percent CI, 0.97–8.16; p=0.055).

The TPORAs tested in the studies were eltrombopag, avatrombopag and lusutrombopag. While there were no significant publication bias (p=0.4) and evidence of heterogeneity (p=0.718) among the studies, the correlation between PVT and TPORA use achieved statistical significance when analysis was restricted to patients treated with eltrombopag (OR, 3.8; 1.14–13.2; p=0.03).

Moreover, in two studies including 1,727 patients, the rates of arterial and venous thromboembolic events were 3.6 percent and 1.1 percent in those who received eltrombopag or placebo, respectively. This corresponded to a significant difference (OR, 3.4; 1.5–7.7; p=0.003).

In a subsequent analysis including three studies (n=514 patients), there was no significant link between TPORA use and PVT incidence in patients with liver disease and thrombocytopaenia undergoing elective invasive procedures (vs placebo: 2.8 percent vs 0.9 percent; OR, 2.6; 0.6–11.6; p=0.212). Heterogeneity and publication bias were likewise nonsignificant.

In the present meta-analysis, the databases of PubMed, SCOPUS, Cochrane and ISI Web of Science were accessed. Aside from case reports, commentaries, review articles and animal studies, papers that did not include an untreated control group were ineligible for inclusion.

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Most Read Articles
Jairia Dela Cruz, 6 days ago
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
Tristan Manalac, 6 days ago
Less than 15 percent of Singaporean adolescents get the recommended 8–10 hours of sleep on a school night, reports a recent study, noting that such short sleep duration is linked to symptoms of depression, overweight or obesity, and poorer self-rated health.
04 Jan 2019
Obstructive sleep apnoea may increase the risk of male-pattern baldness in men with a family history of hair loss, and this association appears to be mediated by low serum transferrin saturation levels related to hypoxia, a study suggests.
6 days ago
Airway type 2 inflammation remains persistent in many asthmatics on inhaled corticosteroids, a new study has shown. These patients tend to be older and have a more severe disease.