Hetrombopag: A promising thrombopoietin receptor agonist for the treatment of primary and secondary immune thrombocytopenia

Immune thrombocytopenia (ITP) is a rare autoimmune disorder characterized by a platelet count below 100 x 10(9)/L. This review aims to comprehensively summarize the current evidence on the use of thrombopoietin receptor agonists (TPO-RAs), with a focus on Hetrombopag, for the treatment of both primary and secondary ITP. Conventional first-line therapies, including glucocorticoids and immunoglobulins, are effective for most ITP patients. Hetrombopag, a novel oral TPO-RA developed in China, has demonstrated superior platelet-raising effects compared to Eltrombopag and shows a more favorable safety profile. Recent clinical trials indicate sustained platelet count improvements in both primary and secondary ITP patients, even after discontinuing concurrent corticosteroid therapy. While initial clinical outcomes of Hetrombopag are promising, additional large-scale, multicenter, randomized controlled trials are required to determine the optimal dosing regimen and confirm long-term efficacy and safety in treating primary and secondary ITP.