PDF(Pubmed)
Abstract：
BACKGROUND: Hydroxyurea is an affordable drug that reduces vaso-occlusive crises and transfusion requirements in sickle cell disease. However, its effectiveness in preventing chronic organ damage is still unclear. This systematic review and meta-analysis aimed to evaluate the role of hydroxyurea in preventing organ morbidity.
METHODS: We included original articles published in English from 1st January 1990 to 31st January 2023, reporting hydroxyurea therapy and organ damage from PubMed, Google Scholar, Scopus, and CrossRef databases. A total of 45 studies with 4681 sickle cell disease patients were evaluated for organ damage.
RESULTS: Our analysis showed that hydroxyurea intervention significantly lowered transcranial Doppler and tricuspid regurgitant velocity, with a standardized mean difference of - 1.03 (- 1.49; - 0.58); I 2 = 96% and - 1.37 (CI - 2.31, - 0.42); I 2 = 94%, respectively. Moreover, the pooled estimate for albuminuria showed a beneficial effect post-hydroxyurea therapy by reducing the risk of albuminuria by 58% (risk ratio of 0.42 (0.28; 0.63); I 2 = 28%).
CONCLUSIONS: Our study found that a hydroxyurea dose above 20 mg/kg/day with a mean rise in HbF by 18.46% post-hydroxyurea therapy had a beneficial role in reducing transcranial doppler velocity, tricuspid regurgitant velocity, albuminuria, and splenic abnormality.
BACKGROUND: PROSPERO CRD42023401187.
METHODS: We included original articles published in English from 1st January 1990 to 31st January 2023, reporting hydroxyurea therapy and organ damage from PubMed, Google Scholar, Scopus, and CrossRef databases. A total of 45 studies with 4681 sickle cell disease patients were evaluated for organ damage.
RESULTS: Our analysis showed that hydroxyurea intervention significantly lowered transcranial Doppler and tricuspid regurgitant velocity, with a standardized mean difference of - 1.03 (- 1.49; - 0.58); I 2 = 96% and - 1.37 (CI - 2.31, - 0.42); I 2 = 94%, respectively. Moreover, the pooled estimate for albuminuria showed a beneficial effect post-hydroxyurea therapy by reducing the risk of albuminuria by 58% (risk ratio of 0.42 (0.28; 0.63); I 2 = 28%).
CONCLUSIONS: Our study found that a hydroxyurea dose above 20 mg/kg/day with a mean rise in HbF by 18.46% post-hydroxyurea therapy had a beneficial role in reducing transcranial doppler velocity, tricuspid regurgitant velocity, albuminuria, and splenic abnormality.
BACKGROUND: PROSPERO CRD42023401187.
摘要：
背景：羟基脲是一种经济实惠的药物，可减少镰状细胞病的血管闭塞危象和输血需求。然而,其预防慢性器官损伤的有效性尚不清楚.本系统综述和荟萃分析旨在评估羟基脲在预防器官发病中的作用。
方法：我们收录了1990年1月1日至2023年1月31日以英文发表的原始文章，报告了PubMed的羟基脲疗法和器官损伤，谷歌学者，Scopus,和CrossRef数据库。共有45项研究对4681例镰状细胞病患者进行了器官损伤评估。
结果：我们的分析表明，羟基脲干预显着降低了经颅多普勒和三尖瓣反流速度，标准化平均差为-1.03(-1.49；-0.58)；I2=96%和-1.37(CI-2.31，-0.42)；I2=94%，分别。此外，蛋白尿的汇总估计值显示,羟基脲治疗后蛋白尿的风险降低了58%(风险比为0.42(0.28;0.63);I2=28%).
结论：我们的研究发现，羟基脲剂量超过20mg/kg/天，羟基脲治疗后HbF平均升高18.46％，对降低经颅多普勒速度有有益作用，三尖瓣反流速度,白蛋白尿,和脾异常.
背景：PROSPEROCRD42023401187。
方法：我们收录了1990年1月1日至2023年1月31日以英文发表的原始文章，报告了PubMed的羟基脲疗法和器官损伤，谷歌学者，Scopus,和CrossRef数据库。共有45项研究对4681例镰状细胞病患者进行了器官损伤评估。
结果：我们的分析表明，羟基脲干预显着降低了经颅多普勒和三尖瓣反流速度，标准化平均差为-1.03(-1.49；-0.58)；I2=96%和-1.37(CI-2.31，-0.42)；I2=94%，分别。此外，蛋白尿的汇总估计值显示,羟基脲治疗后蛋白尿的风险降低了58%(风险比为0.42(0.28;0.63);I2=28%).
结论：我们的研究发现，羟基脲剂量超过20mg/kg/天，羟基脲治疗后HbF平均升高18.46％，对降低经颅多普勒速度有有益作用，三尖瓣反流速度,白蛋白尿,和脾异常.
背景：PROSPEROCRD42023401187。
