Treatment of critical bleeding events in patients with immune thrombocytopenia: a protocol for a systematic review and meta-analysis

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2024年1月6日

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Emily Sirotich,
Hasmik Nazaryan,
Saifur Rahman Chowdhury,
Gordon Guyatt,
Arnav Agarwal,
Russell Leong,
Aaron Wen,
Emily Xu,
Bonnie Liu,
Sushmitha Pallapothu,
Preksha Rathod,
Henry Y. Kwon,
Jared Dookie,
Amirmohammad Shafiee,
Jay Charness,
Jennifer DiRaimo,
Dale Paynter,
Barbara Pruitt,
Gail Strachan,
Rachel Couban,
Zhikang Ye,
Donald M. Arnold

摘要

Background

Critical bleeding events in adults and children with ITP are medical emergencies; however, evidence-based treatment protocols are lacking. Due to the severe thrombocytopenia, (typically platelet count less than 20 × 10⁹/L), a critical bleed portends a high risk of death or disability. We plan to perform a systematic review and meta-analysis of treatments for critical bleeding in patients with ITP that will inform evidence-based recommendations.

Methods

Literature searches will be conducted in four electronic databases: Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed. Eligible studies will be randomized controlled trials or observational studies that enrolled patients with ITP describing one or more interventions for the management of critical bleeding. Title and abstract screening, full-text screening, data extraction, and risk of bias evaluation will be conducted independently and in duplicate using Covidence and Excel. Outcomes will be pooled for meta-analysis where appropriate or summarized descriptively. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology will be used to evaluate the certainty of the evidence. Primary outcomes of interest will include frequency of critical bleeds, mortality and bleeding-related mortality, bleeding resolution, platelet count, and disability.

Discussion

Evidence-based treatments for critical bleeding in patients with ITP are needed to improve patient outcomes and standardize care in the emergency setting.

Systematic review registration

CRD42020161206.