{
  "abstract": "Introduction\n\nTargeted 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-analysis.Methods\n\nFollowing PRISMA-NMA guidelines, five trials, including 660 patients, were analyzed. Comparing rilzabrutinib, HMPL-523 (sovleplenib), and fostamatinib against placebo. The primary outcome was platelet response (≥ 50 × 10⁹/L), while secondary outcomes included adverse events and treatment discontinuation. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using a frequentist random-effects model.Results\n\nAll treatments significantly improved platelet response versus placebo. Sovleplenib 300 mg showed the greatest efficacy (RR = 30.51, 95% CI: 4.33-214.90), followed by rilzabrutinib 400 mg (RR = 16.60, 95% CI: 2.32-118.92), and fostamatinib 100 mg (RR = 6.51, 95% CI: 1.62-26.08). No significant differences were observed in overall adverse events. Treatment discontinuation risk was lowest with fostamatinib (RR = 1.10, 95% CI: 0.29-4.27).Conclusion\n\nTargeted 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-level superiority was established. Therefore, further large head-to-head trials with standardized outcome definitions and longer follow-up durations are needed to confirm long-term efficacy, safety, and consistency of treatment effects across clinical outcomes.Trial registration\n\nThe authors have confirmed clinical trial registration is not needed for this submission.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medicine Al-Quds University Jerusalem Palestine.",
    "Faculty of Medicine An-Najah University Nablus Palestine.",
    "Deaconess Health System Evansville Indiana USA.",
    "Indiana University School of Medicine Indianapolis Indiana USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ayah Abulehia"
    },
    {
      "affs": [
        0
      ],
      "name": "Raneen Bilal Alshareef"
    },
    {
      "affs": [
        0
      ],
      "name": "Shorouq Khateeb"
    },
    {
      "affs": [
        0
      ],
      "name": "Usra Ghanem"
    },
    {
      "affs": [
        1
      ],
      "name": "Amir Abadi"
    },
    {
      "affs": [
        0
      ],
      "name": "Nora Zatar"
    },
    {
      "affs": [
        0
      ],
      "name": "Peter Bael"
    },
    {
      "affs": [
        0
      ],
      "name": "Raghad Sweity"
    },
    {
      "affs": [
        0
      ],
      "name": "Hamid Ghanem"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Hazem Ayesh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/46dy0ssbg020h.bib",
  "cited_by": 0,
  "doi": "10.1002/jha2.70433",
  "fulltext_url": "https://europepmc.org/articles/PMC13677086",
  "id": "46dy0ssbg020h",
  "issns": [
    "2688-6146"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894830",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Platelet Disorders and Treatments"
    ]
  ],
  "openalex": "W7222901245",
  "pdf_url": "https://europepmc.org/articles/PMC13677086?pdf=render",
  "pmcid": "PMC13677086",
  "pmid": "42894830",
  "published": "2026-10-18",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/46dy0ssbg020h.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42894830",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894830"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Platelet Disorders and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Comparative Efficacy and Safety of Bruton Tyrosine Kinase and Spleen Tyrosine Kinase Inhibitors in Immune Thrombocytopenia: A Network Meta-Analysis of Clinical Trials.",
  "title_text": "Comparative Efficacy and Safety of Bruton Tyrosine Kinase and Spleen Tyrosine Kinase Inhibitors in Immune Thrombocytopenia: A Network Meta-Analysis of Clinical Trials.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/46dy0ssbg020h",
  "venue": "EJHaem",
  "versions": []
}