Related Experiment Video

Updated: Jan 26, 2026

Quantifying Agonist Activity at G Protein-coupled Receptors
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Quantifying Agonist Activity at G Protein-coupled Receptors

Published on: December 26, 2011

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Optimal use of thrombopoietin receptor agonists in immune thrombocytopenia

Hanny Al-Samkari1, David J Kuter2

  • 1Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Suite 118, Room 112, Zero Emerson Place, Boston, MA 02114, USA.

Therapeutic Advances in Hematology
|April 23, 2019
PubMed

The thrombopoietin receptor agonists (TPO-RAs) are a class of platelet growth factors commonly used to treat immune thrombocytopenia (ITP). There are three agents that have been investigated for the treatment of chronic ITP: the peptide agent romiplostim and the small molecule agents eltrombopag and avatrombopag. These agents offer a higher clinical response rate than most other ITP therapies but may require indefinite use. This review is a critical appraisal of the TPO-RAs in adult ITP, defining the optimal patient groups to receive these agents and assisting the hematologist with agent choice, goals of treatment, dosing strategies, and toxicity management. Use of endogenous thrombopoietin levels to predict response to eltrombopag and romiplostim treatment is discussed and alternative dosing protocols suited for certain patient subgroups are described. Finally, indications for discontinuation and combination therapy with other agents are considered.

Keywords:
ITPavatrombopageltrombopagimmune thrombocytopeniaplateletsromiplostimthrombopoietinthrombopoietin receptor agonist

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