Abstract:Objective To evaluate the efficacy and safety of avatrombopag in the treatment of thrombocytopenia by Meta-analytic methods. Methods PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid, ClinicalTrials.gov, CNKI, Wanfang, VIP, CBM database, and Chinese Clinical Trial Registry Database were searched. The randomized controlled trials (RCTs) of avatrombopag in the treatment of thrombocytopenia were collected from the earliest records to December 2023. RevMan 5.3 software was used for a Meta-analysis. Results Ten studies were included, all in English, with a total of 980 patients, including 684 in the avatrombopag group and 296 in the control group.The results of Meta-analysis showed that avatrombopag significantly increased the platelet count of thrombocytopenia caused by chronic liver disease ( WMD =30.73, 95% CI : 22.54-38.91,P ＜0.01), autoimmunity ( WMD =22.40, 95% CI : 4.26-40.54,P =0.02),and tumor chemotherapy( WMD =99.13, 95% CI : 36.50-161.76,P =0.002).However, for the platelet response rate and platelet transfusion rate after treatment, avatrombopag could only improve thrombocytopenia caused by chronic liver disease ( RR =4.91, 95% CI : 3.52-6.86,P ＜0.01;RR = 0.35 , 95% CI : 0.28-0.44,P ＜0.01). Conclusion Avatrombopag can significantly increase the platelet count of thrombocytopenia caused by various pathogenies, but there are some differences in the improvement of platelet response rate and platelet transfusion rate after treatment, which is only effective for thrombocytopenia caused by chronic liver disease.