Identifying the efficacy, proper dosing regimen, and safety of recombinant human thrombopoietin (rhTPO) may be beneficial for patients with immune thrombocytopenia (ITP), according to a study recently published in Platelets.

“In conclusion, all the rhTPO regimens in the current study are safe and well-tolerated in resistant/relapsed ITP patients,” the authors wrote.

This open-label, multicenter, parallel-group trial included 287 patients 18 years of age and above who were previously diagnosed with ITP and had either failed or relapsed after glucocorticoid treatment. Mean age was 47.3 years, and the majority (n=200) were female.

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All patients had a diagnosis based on the 2016 version of the Chinese expert consensus on the diagnosis and treatment of primary ITP in adults. All patients had either a platelet count of ≤30×109/L or a higher platelet count with active bleeding.

The researchers administered a daily dose of 7500 U or 15,000 U for 14 days or a dose of 15,000 U or 30,000 U every other day for 14 days, and they aimed to assess variations in platelet count and total response rate from baseline.

The patients who received rhTPO every other day showcased better results than those who received it every day. The patients who underwent treatment with 15,000 U every other day had the highest median increase in platelet count, followed by those given 30,000 U every other day.

Likewise, the total response rate was also better in the group of patients who received 15,000 U every other day, followed by those who received 30,000 U every other day.

Notably, the rate of grade 3 and above adverse events was similar among all treatment groups. Furthermore, the authors did not identify any new safety issues, as all regimens were well tolerated overall.

“The 30,000 U rhTPO once every other day regimen may offer an effective and safe regimen with less frequent injections, but future trials with longer follow-up are needed,” the authors concluded.


Liu X, Bai Y, Wang T, et al. Recombinant human thrombopoietin (rhTPO) of different dosing regimens for refractory/relapsed primary immune thrombocytopenia: a multicenter, randomized controlled trial and pharmacokinetics study. Platelets. Published online January 3, 2023. doi:10.1080/09537104.2022.2157806