Table 2.

Comparison of the thrombopoietin receptor agonists

CharacteristicRomiplostimEltrombopagAvatrombopagLusutrombopagHetrombopag
Molecular structure Peptide Small molecule Small molecule Small molecule Small molecule 
TPO receptor site of action Extracellular domain Transmembrane domain Transmembrane domain Transmembrane domain Transmembrane domain 
Route of administration Subcutaneous Oral Oral Oral Oral 
Dosing frequencya Weekly Daily Daily or less frequently than daily Daily Daily 
Relevant food interactions NA Yes No No Yes 
Liver function test monitoring required No Yes No No No 
Current FDA-approved indications Immune thrombocytopenia (adults and children) Immune thrombocytopenia (adults and children)
Hepatitis C–associated thrombocytopenia
Severe aplastic anemia 
Periprocedural thrombocytopenia in patients with CLD
Immune thrombocytopenia (adults) 
Periprocedural thrombocytopenia in patients with CLD None (approved in China for management of immune thrombocytopenia and severe aplastic anemia) 
CharacteristicRomiplostimEltrombopagAvatrombopagLusutrombopagHetrombopag
Molecular structure Peptide Small molecule Small molecule Small molecule Small molecule 
TPO receptor site of action Extracellular domain Transmembrane domain Transmembrane domain Transmembrane domain Transmembrane domain 
Route of administration Subcutaneous Oral Oral Oral Oral 
Dosing frequencya Weekly Daily Daily or less frequently than daily Daily Daily 
Relevant food interactions NA Yes No No Yes 
Liver function test monitoring required No Yes No No No 
Current FDA-approved indications Immune thrombocytopenia (adults and children) Immune thrombocytopenia (adults and children)
Hepatitis C–associated thrombocytopenia
Severe aplastic anemia 
Periprocedural thrombocytopenia in patients with CLD
Immune thrombocytopenia (adults) 
Periprocedural thrombocytopenia in patients with CLD None (approved in China for management of immune thrombocytopenia and severe aplastic anemia) 

CLD, chronic liver disease. NA, not applicable.

a

Per drug label. Like avatrombopag, eltrombopag can be dosed less frequently than once daily,38  although this is not in the drug label.