CADTH Health Technology Review - Thrombopoietin Receptor Agonists as Second-Line Treatment in Children with

• The review addressed the following policy questions: ▪ In children with ongoing active ITP, what is the overall body of evidence supporting the use of TPO -RAs and rituximab after failure of first-line therapies? ▪ Based on the level and quality of clinical evidence, should the reimbursement of TPO -RAs come earlier in the treatment sequencing for children with ongoing active ITP, instead of bei. [...] A Patient Engagement Officer gave an overview of the purpose and scope of the project and the purpose of the engagement. [...] Risk of Bias Assessment The reviewers used the following risk of bias assessment tools, according to the study design of the included studies: • Outcome-level risk of bias of relevant randomized controlled trials (RCTs), based on the effect of assignment to the intervention (i.e., intention-to-treat effect), was assessed using the Cochrane Risk of Bias tool, version 2 (RoB 2).27 This assessment to. [...] The following items were considered: the risk of bias of the contributing studies, the precision of the effect estimates, the consistency of the evidence (in cases where more than one study contribut es evidence for a comparison-outcome), and the generalizability (or applicability) of the findings. [...] The outcome of HRQoL was subject to additional bias, considering the subjectivity of the outcome, making it vulnerable to influence by knowledge of the intervention received as assessors were aware of the intervention received.