Efficacy and Safety of Recombinant Human Thrombopoietin on Sepsis Patients With Thrombocytopenia: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology

Zongqing Lu¹  Min Yang¹  Yao Zheng¹  Jin Zhang¹  Tianfeng Hua¹  Wenyan Xiao¹ 

[1] The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China;The Second Department of Intensive Care Unit, the Second Affiliated Hospital of Anhui Medical University, Hefei, China;

关键词: sepsis;    thrombocytopenia;    recombinant human thrombopoietin (rhTPO);    platelet;    sepsis-related thrombocytopenia;   

DOI  :  10.3389/fphar.2020.00940

来源: DOAJ

【 摘 要 】

BackgroundThe efficacy and safety of the administration of recombinant human thrombopoietin (rhTPO) in sepsis patients with thrombocytopenia were still inconclusive.ObjectivesTo investigate whether rhTPO is a benefit for sepsis patients with thrombocytopenia.MethodsPubMed, Cochrane library, Embase, China National Knowledge Infrastructure, and Wanfang Database were electronically searched to the randomized controlled trials (RCTs) from inception to March 4, 2020. The primary outcome was the level of platelet (PLT) on the 7th day of treatment, and secondary outcomes were 28-d mortality, the level of coagulation indicators, hepatic and renal function indicators, blood transfusion, and length of intensive care unit (ICU) stay.ResultsTen RCTs involving 681 patients were included. For compared with conventional antibiotic therapy, rhTPO could significantly increase platelet counts (PCs) [standardized mean difference (SMD), 2.61; 95% confidence interval (CI), 1.28–3.94; P < 0.001], decreased 28-d mortality [relative risk (RR), 0.66; 95%CI, 0.46–0.97; P=0.03], transfusion volume of blood products and length of ICU stay. Additionally, for compared with conventional antibiotic therapy combined with intravenous immunoglobulin, the pooled results shown that rhTPO also associated with an improvement of PCs on 7th of treatment (SMD, 0.86; 95%CI, 0.54–1.17; P < 0.001), and a reduced transfusion volume of blood products. However, there were no differences in 28-d mortality and the length of ICU stay.ConclusionsCurrent evidence shown that rhTPO could increase PCs on 7th day of treatment and reduce the transfusion volume of blood products in sepsis-related thrombocytopenia during hospitalization. The conclusions are needed to be verified indeed by more multicenter RCTs due to the limitation of the included studies.

【 授权许可】

Unknown