In terms of adverse events, thrombosis and embolism are concerns, as studies have shown that TPO-RAs may promote platelet activation in immune thrombocytopenic purpura (ITP) patients by increasing platelet microparticle formation and upregulating platelet glycoprotein VI (GPVI) and P-selectin expression (van Dijk et al., 2021). This evidence concerns the gene SELP and autoimmune thrombocytopenic purpura.