How Do Thrombopoietic Agents Work?

Thrombopoietic agents also known as thrombopoiesis-stimulating agents (thrombopoiesis is the formation of platelets in the bone marrow) are recombinant forms of human thrombopoietin (TPO), a hematopoietic growth factor that regulates thrombocytosis (high platelet count) and are used to treat thrombocytopenia (low platelet count) because of chemotherapy, chronic liver disease, and myelodysplastic syndromes. 

TPO is an endogenous ligand that binds to TPO receptors present on megakaryocyte precursors, megakaryocytes, and platelets. This promotes the proliferation of  megakaryocytic cells and increases platelets production.

The therapeutic use of human TPO may provoke an immune response, leading to the development of neutralizing anti-TPO antibodies. Recombinant forms were developed to prevent immunogenicity. They act as TPO receptor agonists and mimic the platelet-promoting action of human TPO.

Thrombopoietic agents are used to treat:

• Thrombocytopenia caused by other diseases
• Immune thrombocytopenic purpura
• Aplastic anemia

Side effects of thrombopoietic agents may include:

• Headache
• Dizziness
• Nausea
• Fatigue
• Sleeplessness
• Muscle and joint pain
• Formation of life-threatening clots
• Bleeding tendency
• Bone marrow fibrosis
• Abdominal pain
• Skin rash
• Upper respiratory tract infections
• Contusion
• Anaphylaxis (life-threatening allergic reactions)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of thrombopoietic agents include:

• Avatrombopag (Doptelet)
• Lusutrombopag (Mulpleta)
• Romiplostim (Nplate)