{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:14:07Z","timestamp":1787062447480,"version":"build-2736575974"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    The introduction of thrombopoietin receptor agonists (TPO\u2010RAs) led to a paradigm shift in the management of immune thrombocytopenia (ITP). However, TPO\u2010RAs are not approved for use during pregnancy due to the absence of evidence and concerns for possible effects on the fetus due to their expected transplacental transfer. This comprehensive review examines the safety and efficacy of TPO\u2010RA in 45 pregnancies of women with ITP (romiplostim\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200922; eltrombopag\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200921; both in the same pregnancy\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092). Mothers experienced failure of the median of three treatment lines during pregnancy prior to TPO\u2010RA administration. A platelet response (&gt;30\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L) was seen in 86.7% of cases (including a complete response &gt;100\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L in 66.7%) and was similar between eltrombopag and romiplostim (87.0% and 83.3%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.99). The maternal safety profile was favourable, with no thromboembolic events encountered. Neonatal thrombocytopenia was noted in one third of cases, with one case of ICH grade 3, and neonatal thrombocytosis was observed in three cases. No other neonatal adverse events attributable to TPO\u2010RAs were seen. This review suggests that the use of TPO\u2010RA during pregnancy is associated with a high response rate and appears safe. Nevertheless, TPO\u2010RA should not be routinely used in pregnancy and should be avoided in the first trimester until further evidence is accumulated.\n                  <\/jats:p>","DOI":"10.1111\/bjh.19161","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T05:03:30Z","timestamp":1697173410000},"page":"872-885","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Treatment of immune thrombocytopenia during pregnancy with thrombopoietin receptor agonists"],"prefix":"10.1111","volume":"203","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2472-5204","authenticated-orcid":false,"given":"Amihai","family":"Rottenstreich","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Zucker School of Medicine at Hofstra\/Northwell  New York New York USA"},{"name":"Laboratory of Blood and Vascular Biology Rockefeller University  New York New York USA"},{"name":"Department of Obstetrics and Gynecology Hadassah\u2010Hebrew University Medical Center  Jerusalem Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2884-9247","authenticated-orcid":false,"given":"James B.","family":"Bussel","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Pediatrics Weill Cornell Medicine  New York New York 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