{
  "abstract": "Background\n\nSplenectomy and thrombopoietin receptor agonists (TPO-RAs) are recommended second-line therapies for immune thrombocytopenia. Although guidelines recommend tailoring second-line treatments to patient characteristics, this approach is often unclear in real-world practice.Objectives\n\nWe examined claims-based time to next treatment (TTNT) and safety outcomes after splenectomy or TPO-RA as a second-line therapy using nationally representative Korean claims data.Methods\n\nPatients diagnosed with immune thrombocytopenia between 2002 and 2021 were included. From the eligible cohort, we identified patients whose index second-line treatment was splenectomy (group 1) or TPO-RA without prior splenectomy (group 2). Propensity score matching was performed between patients in both groups who had received corticosteroids as first-line treatment.Results\n\nAfter matching, 447 group 1 and 57 group 2 patients were analyzed. Subsequent treatment was administered to 82.3% and 61.4% of patients in groups 1 and 2, respectively. Median TTNTs were 5.80 and 3.03 months in groups 1 and 2, respectively. Estimated TTNT curves diverged after 24 months, with a longer TTNT observed in the TPO-RA group. Pneumococcal infections occurred in 3.1% of patients in group 1 and none in group 2. Venous thromboembolism (VTE) occurred in 10.5% and 15.7% of patients in groups 1 and 2, respectively. The observed time to VTE was shorter in group 2 than in group 1.Conclusion\n\nPatients treated with TPO-RAs as a second-line therapy showed a longer TTNT after 24 months, whereas VTE occurred earlier in the TPO-RA group. However, these findings should be interpreted with caution because of residual confounding.",
  "abstract_shown": true,
  "affiliations": [
    "Graduate School of Software and Artificial Intelligence Convergence, Korea University, Seoul, Republic of Korea.",
    "Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.",
    "Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.",
    "Department of Obstetrics & Gynecology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hyung-Jun Lim"
    },
    {
      "affs": [
        1
      ],
      "name": "Kunye Kwak"
    },
    {
      "affs": [
        1
      ],
      "name": "Changgon Kim"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Yoon Seok Choi"
    },
    {
      "affs": [
        1
      ],
      "name": "Yong Park"
    },
    {
      "affs": [
        1
      ],
      "name": "Byung Soo Kim"
    },
    {
      "affs": [
        3
      ],
      "name": "Ki Hoon Ahn"
    },
    {
      "affs": [
        1
      ],
      "name": "Ka-Won Kang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/92zy10gqcnf0d.bib",
  "cited_by": 0,
  "doi": "10.1016/j.rpth.2026.106992",
  "fulltext_url": "https://europepmc.org/articles/PMC13695308",
  "id": "92zy10gqcnf0d",
  "issns": [
    "2475-0379"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927077",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Platelet Disorders and Treatments"
    ]
  ],
  "openalex": "W7214808334",
  "pdf_url": "https://europepmc.org/articles/PMC13695308?pdf=render",
  "pmcid": "PMC13695308",
  "pmid": "42927077",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/92zy10gqcnf0d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927077",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927077"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Platelet Disorders and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Treatment patterns and safety outcomes after splenectomy or thrombopoietin receptor agonists as second-line therapy for immune thrombocytopenia: Korean claims-based study.",
  "title_text": "Treatment patterns and safety outcomes after splenectomy or thrombopoietin receptor agonists as second-line therapy for immune thrombocytopenia: Korean claims-based study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/92zy10gqcnf0d",
  "venue": "Research and practice in thrombosis and haemostasis",
  "versions": []
}