摘要：目的：應用血小板受體激動劑(TPO-RAs)已經升級為ITP的二線治療，但是這類藥物在SLE相關的ITP中的有效性和安全性尚未驗證。方法：該研究為2009年到2016年間的多中心回顧性隊列研究。參與中心(n=11)為法國成人ITP國家網絡中的二級或者三級醫院。結果：納入18例TPO-RAs治療的SLE-ITP患者;10(55%)例aPL陽性，5例(27%)為明確的抗磷脂綜合征。除1例患者外，所有(94%)患者均對TPO-RAs有反應。對TPO-RAs隨訪平均14.7個月後，4位患者中發生4例動脈栓塞事件(包括1例惡性APS)。在無APS或者aPLs患者中發生2例靜脈血栓事件。結論：該研究提示SLE患者開始TPO-RA前應該進行係統的aPLs檢查。aPL陽性患者，尤其是明確的APS或者抗凝治療不是最佳治療的患者，應該考慮其他治療(如果可能)。

        附原文:ObjectivesThe use of thrombopoietin-receptor agonists (TPO-RAs) has increased as a second-line therapy in ITP, but the efficacy and safety of such drugs has not been evaluated in SLE-associated ITP.MethodsThis was a multicentre retrospective cohort study from 2009 to 2016. Participating centres (n = 11) were secondary- or tertiary-care hospitals belonging to the French national network for adult ITPResultsWe included 18 patients with SLE-ITP treated with TPO-RAs; 10 (55%) had aPL, 5 (27%) showing definite APS. Except for one patient, all(94%) achieved response with TPO-RAs overall. After a median follow-up of 14.7 months with TPO-RAs, four arterial thrombosis events (including one catastrophic APS) occurred in four patients. Two venous thrombosis events occurred in a patient without APS or aPLs.Conclusion Our results suggest that aPLs should be systematically screened before TPO-RA initiation in patients with SLE. With aPL positivity, alternative therapy should be discussed (if possible), especially in patients with definite APS or suboptimal adherence to anti-coagulation therapy.

        引自：GuittonZelie ,Terriou Louis ,Lega Jean-Christophe ,etal.Risk of thrombosis with anti-phospholipid syndrome in systemic lupus erythematosus treated with thrombopoietin-receptor agonists.Rheumatology (Oxford) 2018 May 10.