Currently, three TPO-RAs are approved by the Food and Drug Administration (FDA) for use in adult patients with primary ITP who are refractory to first-line therapies: romiplostim (ROM), approved as a once-weekly subcutaneous injection; eltrombopag (ELT); and avatrombopag (AVA), approved as a once-daily oral treatment (4–6). This evidence concerns the gene TPO and autoimmune thrombocytopenic purpura.