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Hetrombopag is an orally bioavailable, small molecule thrombopoietin receptor agonist developed for the treatment of thrombocytopenia and aplastic anaemia. It binds to and stimulates the transmembrane domain of the platelet thrombopoietin receptor (TPO-R), leading to activation of downstream signaling pathways such as JAK/STAT, PI3K/AKT, and ERK1/2. This results in proliferation and differentiation of megakaryocytic lineage cells and increased platelet production[1][6][8]. Hetrombopag has been approved in China as a second-line treatment for primary immune thrombocytopenia (ITP) and severe aplastic anaemia (SAA) in adults, with ongoing phase III trials for chemotherapy-induced thrombocytopenia[3][4].
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