In conclusion, this systematic review and meta-analysis demonstrated that TPO-RAs are effective and safe agents for the treatment of primary ITP, and the results of this analysis support the use of TPO-RAs as second-line treatments for persistent and chronic ITP patients who are unresponsive to or relapse after receiving previous first-line ITP therapies. The gene discussed is TPO; the disease is autoimmune thrombocytopenic purpura.