{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:39:35Z","timestamp":1792348775770,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Targeted kinase inhibitors have shown statistically and clinically significant improvements in platelet response among patients with primary ITP, supporting their utility as effective targeted therapeutic strategies. We evaluated the efficacy and safety of Bruton tyrosine kinase (BTK) and spleen tyrosine kinase (SYK) inhibitors in primary immune thrombocytopenia (ITP) using network meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA\u2010NMA guidelines, five trials, including 660 patients, were analyzed. Comparing rilzabrutinib, HMPL\u2010523 (sovleplenib), and fostamatinib against placebo. The primary outcome was platelet response (\u2265\u00a050\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L), while secondary outcomes included adverse events and treatment discontinuation. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using a frequentist random\u2010effects model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All treatments significantly improved platelet response versus placebo. Sovleplenib 300\u00a0mg showed the greatest efficacy (RR\u00a0=\u00a030.51, 95% CI: 4.33\u2013214.90), followed by rilzabrutinib 400\u00a0mg (RR\u00a0=\u00a016.60, 95% CI: 2.32\u2013118.92), and fostamatinib 100\u00a0mg (RR\u00a0=\u00a06.51, 95% CI: 1.62\u201326.08). No significant differences were observed in overall adverse events. Treatment discontinuation risk was lowest with fostamatinib (RR\u00a0=\u00a01.10, 95% CI: 0.29\u20134.27).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Targeted kinase inhibitors demonstrated clinically meaningful improvements in platelet response in primary ITP, supporting their role as effective targeted therapeutic options. Comparative safety profiles varied, and no clear class\u2010level superiority was established. Therefore, further large head\u2010to\u2010head trials with standardized outcome definitions and longer follow\u2010up durations are needed to confirm long\u2010term efficacy, safety, and consistency of treatment effects across clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70433","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:44:36Z","timestamp":1792345476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Efficacy and Safety of Bruton Tyrosine Kinase and Spleen Tyrosine Kinase Inhibitors in Immune Thrombocytopenia: A Network Meta\u2010Analysis of Clinical Trials"],"prefix":"10.1002","volume":"7","author":[{"given":"Ayah","family":"Abulehia","sequence":"first","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raneen Bilal","family":"Alshareef","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shorouq","family":"khateeb","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usra","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Abadi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine An\u2010Najah University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Zatar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bael","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Sweity","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Quds University  Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem","family":"Ayesh","sequence":"additional","affiliation":[{"name":"Deaconess Health System  Evansville Indiana USA"},{"name":"Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024015494"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100609.2009.01247.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24463"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14446"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201001\u2010129155"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S331675"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21616"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102004\u201003\u20101168"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010024\u201005824\u20107"},{"key":"e_1_2_12_12_1","unstructured":"A.Abulehia 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