Impact of hydroxyurea dose and adherence on hematologic outcomes for children with sickle cell anemia

Autor: Susan E. Creary, Chase Beeman, Joseph Stanek, Kathryn King, Patrick T. McGann, Sarah H. O'Brien, Robert I. Liem, Jane Holl, Sherif M. Badawy
Rok vydání: 2022
Předmět:
Zdroj: Pediatr Blood Cancer
ISSN: 1545-5017
1545-5009
DOI: 10.1002/pbc.29607
Popis: BACKGROUND: Hydroxyurea is the primary treatment for sickle cell anemia (SCA), yet real-world implementation in high-income settings is suboptimal. Variation in prescribed hydroxyurea dose and patient adherence in these settings can both affect actual exposure to hydroxyurea. Quantifying the contributions of hydroxyurea dose and medication adherence to the relationship between hydroxyurea exposure and hematologic parameters could inform strategies to optimize exposure and improve outcomes. PROCEDURE: We evaluated the relationship between hydroxyurea exposure, defined by average prescribed dose and adherence, and hematologic parameters using data from children with SCA who were enrolled in two prospective hydroxyurea adherence studies. Hydroxyurea adherence was assessed by video directly observed therapy or electronic pill bottle and medication administration record. Average prescribed dose was abstracted from prescriptions in patients’ electronic medical record. Participants with a hydroxyurea exposure >20mg/kg/day and ≤20 mg/kg/day were included in the higher and lower exposure groups, respectively. RESULTS: Forty-five participants are included in the analysis (56% male; median age 12 years (range 2–19); 98% Black). Higher exposed participants (n=23) were prescribed a higher dose (27.2 vs. 24.4 mg/kg/day, P=0.002) and had better adherence (0.92 vs. 0.71, P=
Databáze: OpenAIRE
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