Thrombopoietin Receptor Agonists in Children With Immune Thrombocytopenia: A New Therapeutic Era

Background and objective: Immune thrombocytopenia (ITP) is a common bleeding disorder in child-hood. The management of ITP in children is controversial, requiring personalized assessment of patients and therapeutic choices. Thrombopoietin receptor agonists (TPO-RAs), eltrombopag and romiplostim, have been shown to be safety and effective for the treatment of pediatric ITP. The aim of our research is defining the role of thrombopoietin receptor agonists in the management of pediatric ITP. Methods: This review focuses on the use of TPO-RAs in pediatric ITP, in randomized trials and in clinical routine, high-lighting their key role in management of the disease. Results: Eltrombopag and romiplostim appear effec-tive treatment options for children with ITP. Several clinical studies have assessed that the use of TPO-RAs increases platelet count, decreases bleeding symptoms and improves health-related quality of life. Moreover, TPO-RAs are well tolerated with minor side effects. Conclusion: Although TPO-RAs long term efficacy and safety still require further investigations, their use is gradually expanding in clinical practice of children with ITP