Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease

Kratovil, Tonya; Bulas, Dorothy; Driscoll, Monica; Speller‐Brown, Barbara; McCarter, Robert; Minniti, Caterina P.

doi:10.1002/pbc.20819

Cited by 79 publications

(51 citation statements)

References 18 publications

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“…353 In another study, the adjusted mean change in TCD velocities was -13.0 cm/s (95% CI, -20.19 to -5.92) in an hydroxyurea-treated group and ϩ4.72 cm/s (95% CI, -3.24 to 12.69) in controls (PϽ0.001). 369 Children (nϭ59) for whom hydroxyurea therapy was initiated for clinical severity who had pretreatment baseline TCD measurements, 37 of whom had increased flow velocities (Ն140 cm/s), were enrolled in a prospective phase 2 trial with TCD velocities measured at maximum tolerated dose and 1 year later. 370 At hydroxyurea maximum tolerated dose [mean Ϯ1 standard deviation (SD)ϭ27.9Ϯ2.7 mg/kg per day), decreases were observed in bilateral middle carotid artery velocities.…”

Section: Sickle Cell Diseasementioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,298

577

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Background and Purpose-This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council Scientific Statement Oversight Committee and the AHA Manuscript Oversight Committee. The writing group used systematic literature reviews (covering the time since the last review was published in 2006 up to April 2009), reference to previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate recommendations using standard AHA criteria (Tables 1 and 2). All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. The guideline underwent extensive peer review by the Stroke Council leadership and the AHA scientific statements oversight committees before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Schemes for assessing a person's risk of a first stroke were evaluated. Risk factors or risk markers for a first stroke were classified according to potential for modification (nonmodifiable, modifiable, or potentially modifiable) and strength of evidence (well documented or less well documented). Nonmodifiable risk factors include age, sex, low birth weight, race/ethnicity, and genetic predisposition. Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia, carotid artery stenosis, sickle cell disease, postmenopausal hormone therapy, poor diet, physical inactivity, and obesity and body fat

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Section: Sickle Cell Diseasementioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,298

577

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show abstract

“…Several case series and retrospective reviews have found a benefit of hydroxyurea in lowering TCD velocities in patients with abnormal TCD velocities, but no history of stroke [163,164]. As mentioned previously, in the BABY HUG study, TCD velocities increased at a slower rate in infants who received hydroxyurea compared with those who received standard care [145].…”

Section: Discontinuation Of Primary Stroke Prevention Strategiesmentioning

confidence: 79%

Stroke in patients with sickle cell disease

Webb

Kwiatkowski

2013

Expert Review of Hematology

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“…Recognizing this significant barrier, several investigators evaluated hydroxyurea therapy as an alternative to regular transfusions for stroke prevention. Based on several studies that consistently demonstrated a decrease in TCD measurements with hydroxyurea therapy [66][67][68][69][70][71], the NHLBI sponsored the Transcranial Doppler With Transfusions Switching to Hydroxyurea (TWiTCH) trial. For primary stroke prevention, the TWiTCH trial randomly allotted children with hemoglobin SS and hemoglobin S/beta-0-thalassemia with elevated TCD velocities without strokes and were on a regimen of regular transfusions to receive either regular blood transfusion therapy or hydroxyurea therapy escalated to maximum tolerated dose.…”

Section: Stroke Prevention In Scamentioning

confidence: 99%

Evolution of sickle cell disease from a life‐threatening disease of children to a chronic disease of adults: The last 40 years

2015

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Over the past 40 years, public health measures such as universal newborn screening, penicillin prophylaxis, vaccinations, and hydroxyurea therapy have led to an impressive decline in sickle cell disease (SCD)-related childhood mortality and SCD-related morbidity in high-income countries. We remain cautiously optimistic that the next 40 years will be focused on meeting current challenges in SCD by addressing chronic complications of SCD to reduce mortality and improve quality of life in a growing population of adults with SCD in high-income countries, while simultaneously decreasing the disparity of medical care between high and low-income countries.

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Hydroxyurea therapy lowers TCD velocities in children with sickle cell disease

Cited by 79 publications

References 18 publications

Guidelines for the Primary Prevention of Stroke

Guidelines for the Primary Prevention of Stroke

Stroke in patients with sickle cell disease

Evolution of sickle cell disease from a life‐threatening disease of children to a chronic disease of adults: The last 40 years

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