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Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria.
J Trop Pediatr. 2020 06 01; 66(3):290-298.JT

Abstract

BACKGROUND

Hydroxyurea has been shown to positively modify sickle cell disease pathogenesis, but its use is low among Nigerian sickle cell anaemia (SCA) patients because of effectiveness and safety concerns.

METHODS

We conducted a quasi-experimental study to evaluate the effectiveness and safety of hydroxyurea in 54 SCA children aged 4-17 years. Clinical and haematological parameters were compared at baseline and 12 months after hydroxyurea therapy. The participants were monitored for adverse events. The parameters were compared using relative risk and Wilcoxon Signed-Rank Test.

RESULTS

The number of subjects who had more than two episodes of painful crises reduced from 27 (50%) to 2 (2.7%) (p < 0.001), while those who had acute chest syndrome reduced from 6 (11.1%) to 0 (0.0%; p < 0.001). The risk of being transfused more than once was 0.11 times the risk in the 12 months period preceding therapy (95% CI = 0.02-0.85; p = 0.016). Similarly, the risk of hospital stay >7 days was 0.08 times the risk at the baseline (95% CI = 0.02-0.24; p < 0.0001). The median haematocrit and percentage foetal haemoglobin increased from 26 to 28% and 7.8 to 14%, respectively (p < 0.0001). A dose-dependent but reversible leucopenia was observed among six children (11.1%), otherwise, hydroxyurea was safe in the study population.

CONCLUSION

Hydroxyurea is effective and safe in SCA children in Jos, Nigeria. The findings could strengthen educational programme aimed at improving the utilization of hydroxyurea among SCA children.

Authors+Show Affiliations

Department of Paediatrics, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.Department of Paediatrics, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.Division of Hematology-Oncology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.Department of Paediatrics, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.Department of Community Medicine, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.Department of Paediatrics, Lagos State University Teaching Hospital, Lagos, Nigeria.Department of Community Medicine, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.Department of Obstetrics and Gynaecology, College of Health Sciences, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31608959

Citation

Ofakunrin, Akinyemi O D., et al. "Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria." Journal of Tropical Pediatrics, vol. 66, no. 3, 2020, pp. 290-298.
Ofakunrin AOD, Oguche S, Adekola K, et al. Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria. J Trop Pediatr. 2020;66(3):290-298.
Ofakunrin, A. O. D., Oguche, S., Adekola, K., Okpe, E. S., Afolaranmi, T. O., Diaku-Akinwumi, I. N., Zoakah, A. I., & Sagay, A. S. (2020). Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria. Journal of Tropical Pediatrics, 66(3), 290-298. https://doi.org/10.1093/tropej/fmz070
Ofakunrin AOD, et al. Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria. J Trop Pediatr. 2020 06 1;66(3):290-298. PubMed PMID: 31608959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness and Safety of Hydroxyurea in the Treatment of Sickle Cell Anaemia Children in Jos, North Central Nigeria. AU - Ofakunrin,Akinyemi O D, AU - Oguche,Stephen, AU - Adekola,Kehinde, AU - Okpe,Edache S, AU - Afolaranmi,Tolulope O, AU - Diaku-Akinwumi,Ijeoma N, AU - Zoakah,Ayuba I, AU - Sagay,Atiene S, PY - 2019/10/15/pubmed PY - 2020/12/2/medline PY - 2019/10/15/entrez KW - Nigeria KW - adverse events KW - effectiveness KW - hydroxyurea KW - safety KW - sickle cell anaemia SP - 290 EP - 298 JF - Journal of tropical pediatrics JO - J Trop Pediatr VL - 66 IS - 3 N2 - BACKGROUND: Hydroxyurea has been shown to positively modify sickle cell disease pathogenesis, but its use is low among Nigerian sickle cell anaemia (SCA) patients because of effectiveness and safety concerns. METHODS: We conducted a quasi-experimental study to evaluate the effectiveness and safety of hydroxyurea in 54 SCA children aged 4-17 years. Clinical and haematological parameters were compared at baseline and 12 months after hydroxyurea therapy. The participants were monitored for adverse events. The parameters were compared using relative risk and Wilcoxon Signed-Rank Test. RESULTS: The number of subjects who had more than two episodes of painful crises reduced from 27 (50%) to 2 (2.7%) (p < 0.001), while those who had acute chest syndrome reduced from 6 (11.1%) to 0 (0.0%; p < 0.001). The risk of being transfused more than once was 0.11 times the risk in the 12 months period preceding therapy (95% CI = 0.02-0.85; p = 0.016). Similarly, the risk of hospital stay >7 days was 0.08 times the risk at the baseline (95% CI = 0.02-0.24; p < 0.0001). The median haematocrit and percentage foetal haemoglobin increased from 26 to 28% and 7.8 to 14%, respectively (p < 0.0001). A dose-dependent but reversible leucopenia was observed among six children (11.1%), otherwise, hydroxyurea was safe in the study population. CONCLUSION: Hydroxyurea is effective and safe in SCA children in Jos, Nigeria. The findings could strengthen educational programme aimed at improving the utilization of hydroxyurea among SCA children. SN - 1465-3664 UR - https://www.unboundmedicine.com/medline/citation/31608959/Effectiveness_and_Safety_of_Hydroxyurea_in_the_Treatment_of_Sickle_Cell_Anaemia_Children_in_Jos_North_Central_Nigeria_ L2 - https://academic.oup.com/tropej/article-lookup/doi/10.1093/tropej/fmz070 DB - PRIME DP - Unbound Medicine ER -