Evidence review of hydroxyurea for the prevention of sickle cell complications in low-income countries. — Peter Medawar Building for Pathogen Research Cookies on this website We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings. Accept all cookies Reject all non-essential cookies Site Map Accessibility Contact Cookies Log in Home About us Sir Peter Medawar Find us Contact us Jobs and Vacancies Latest news and events Shared Cytometry Facility Research Dphil Studentships DPhil Project Funding Programs Medawar Courses Graduate Studies Seminars Our team Funding Bodies Intranet COVID and Returning to Work Weekly WiP Contacts Research checklist Resources Policies New to Oxford Search Publications Evidence review of hydroxyurea for the prevention of sickle cell complications in low-income countries. Evidence review of hydroxyurea for the prevention of sickle cell complications in low-income countries. Mulaku M., Opiyo N., Karumbi J., Kitonyi G., Thoithi G., English M. Hydroxyurea is widely used in high-income countries for the management of sickle cell disease (SCD) in children. In Kenyan clinical guidelines, hydroxyurea is only recommended for adults with SCD. Yet many deaths from SCD occur in early childhood, deaths that might be prevented by an effective, disease modifying intervention. The aim of this review was to summarise the available evidence on the efficacy, effectiveness and safety of hydroxyurea in the management of SCD in children below 5 years of age to support guideline development in Kenya. We undertook a systematic review and used the Grading of Recommendations Assessment, Development and Evaluation system to appraise the quality of identified evidence. Overall, available evidence from 1 systematic review (n=26 studies), 2 randomised controlled trials (n=354 children), 14 observational studies and 2 National Institute of Health reports suggest that hydroxyurea may be associated with improved fetal haemoglobin levels, reduced rates of hospitalisation, reduced episodes of acute chest syndrome and decreased frequency of pain events in children with SCD. However, it is associated with adverse events (eg, neutropenia) when high to maximum tolerated doses are used. Evidence is lacking on whether hydroxyurea improves survival if given to young children. Majority of the included studies were of low quality and mainly from high-income countries. Overall, available limited evidence suggests that hydroxyurea may improve morbidity and haematological outcomes in SCD in children aged below 5 years and appears safe in settings able to provide consistent haematological monitoring. Original publication DOI 10.1136/archdischild-2012-302387 Type Journal article Journal Arch Dis Child Publication Date 11/2013 Volume 98 Pages 908 - 914 Keywords Genetics, Haematology, Anemia, Sickle Cell, Antisickling Agents, Child, Preschool, Developing Countries, Evidence-Based Medicine, Fetal Hemoglobin, Hospitalization, Humans, Hydroxyurea, Infant, Pain © 2022 The Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, OX1 3SY, United Kingdom Freedom of Information Privacy Policy Data Collected on this Website Copyright Accessibility Statement Medical Sciences Division Oxford University Some images courtesy of NHGRIZ Site Map Accessibility Contact Cookies Log in Welcome About us Sir Peter Medawar Find us Jobs and Vacancies Latest news and events Shared Cytometry Facility Research Research Home COVID Research NDM Research Groups Barnes Group Dunachie Group Frater Group Goulder Group Klenerman Group Matthews Group Simmonds Group Wheeler Group Tropical Medicine Research Groups Ariana Group English Group Marsh (Kevin) Group Wills Group Dunachie Group Zoology Research Groups Faria Group Gupta Group Katzourakis Group Lourenço Group Maiden Group McLean Group Pybus Group Smith Group Dphil Studentships DPhil Project Funding Programs Medawar Courses Medawar Courses Graduate Studies Graduate Studies Seminars Seminars Our team Funding Bodies Funding Bodies Intranet COVID and Returning to Work Weekly WiP Key contacts Research checklist Resources Policies University Policies Out of Hours Working Fire Safety Bomb Threat Information security - Data breach Confidential waste New to Oxford