Geographic Differences in Phenotype and Treatment of Children with Sickle Cell Anemia from the Multinational DOVE Study
Autor: | Raffaella Colombatti, Suqin Yao, Hoda Hassab, Miguel R. Abboud, Chunmei Zhou, Baba Inusa, Patricia B. Brown, Joseph A. Jakubowski, Lori E. Heath, Matthew M. Heeney, David C. Rees, Bernhards Ogutu, Carolyn Hoppe |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Prasugrel Demographics Immunology lcsh:Medicine Biochemistry Article 03 medical and health sciences 0302 clinical medicine Disease severity Internal medicine hemic and lymphatic diseases Severity of illness geographic global phenotypic pattern sickle cell disease vaso-occlusive crises (voc) medicine 030212 general & internal medicine Adverse effect business.industry lcsh:R General Medicine Cell Biology Hematology medicine.disease Michigan Alcoholism Screening Test Sickle cell anemia Acute chest syndrome Multinational corporation 030220 oncology & carcinogenesis business Body mass index Regional differences Resource utilization Dove 030215 immunology medicine.drug Demography |
Zdroj: | Journal of Clinical Medicine Volume 8 Issue 11 Journal of Clinical Medicine, Vol 8, Iss 11, p 2009 (2019) |
ISSN: | 2077-0383 |
Popis: | Background: DOVE (Determining Effects of Platelet Inhibition on Vaso-Occlusive Events) was a Phase 3, randomized, double-blind, placebo-controlled study conducted in children with sickle cell anemia at 51 sites in 13 countries across four continents. Procedure: Data from DOVE were assessed for regional differences in subject phenotype and treatment. Demographics, baseline clinical and laboratory data, hydroxyurea (HU) use, vaso-occlusive crisis (VOCs composite endpoint of painful crisis or acute chest syndrome (ACS, Beijing, China)), serious adverse events (SAEs, Florence, Italy), hospitalization, and treatments were compared across the Americas, Europe, North Africa/Middle East, and Sub-Saharan Africa (SSA). Results: Race, body mass index, and blood pressures differed by region. Pre-enrollment VOCs were highest in the Americas. For subjects not on HU, baseline hemoglobin was lowest in SSA reticulocyte count was lowest in the Americas. Within SSA, Kenya subjects presented higher baseline hemolysis. Painful crisis was the most common SAE, followed by ACS in the Americas and infections in other regions. VOC rate and percentage of VOC hospitalizations were highest in Europe. Regardless of region, most VOCs were treated with analgesics approximately half were treated with intravenous fluids. The proportion of VOC-related transfusions was greatest in Europe. Lengths of hospital stay were similar across regions. Conclusions: Overall differences in SAEs and hospitalization for VOCs may be due to cultural diversities, resource utilization, disease severity, or a combination of factors. These data are of importance for the planning of future trials in SCA in a multinational setting. |
Databáze: | OpenAIRE |
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