Study selection and data extraction
Duplicate records were removed, and records retrieved via electronic search were then downloaded and imported into a Reference Manager database and uploaded to InsightScope, a web platform specifically designed to facilitate systematic reviews (KoH).7Records were appraised against the inclusion criteria using a three-step method: initial review for inclusion based on defined criteria (MS, KoH), abstract review (LI, SD) with arbitration (ML, RK, JL), and full-text review (LI, SD) with arbitration (ML, RK, JL). All included records subsequently underwent data extraction independently by two reviewers (LI, SD). Variables of interest included country, study design, patient population, refractory ITP definition, treatment regimen, patient outcomes, and laboratory testing.