2020
DOI: 10.1182/blood-2020-141436
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Randomized Controlled Trial of Fixed Low-Vs Moderate-Dose Hydroxyurea for Primary Stroke Prevention in Sub-Saharan Africa: Final Results of the Spring Trial

Abstract: Introduction: In children with sickle cell anemia (SCA) without transcranial Doppler (TCD) screening, the incidence rates of ischemic strokes is approximately the same among children living in low- and high- low-resource settings (Pediatr Neurol. 2019;95:73-78.) with a prevalence of ~ 11%. However, in high-income settings, the standard use of TCD ultrasonography, coupled initially with monthly blood transfusion therapy has dropped the stroke prevalence to < 1%. In a low-income setting, such as Nigeria, … Show more

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Cited by 4 publications
(3 citation statements)
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“…A recent phase III, randomized control trial in sub-Saharan African, comparing low-dose vs. moderate-dose hydroxyurea for stroke prevention in children with sickle cell disease, found no difference in stroke prevention between the two groups. Importantly, low-dose hydroxyurea was superior to no treatment for prevention of strokes in children with abnormal TCD values and sickle cell disease, suggesting that this treatment is promising as a lower cost alternative for chronic blood transfusion therapy for children with sickle cell disease in low-income and middle-income countries [10,11].…”
Section: Global Impact and Incidencementioning
confidence: 99%
“…A recent phase III, randomized control trial in sub-Saharan African, comparing low-dose vs. moderate-dose hydroxyurea for stroke prevention in children with sickle cell disease, found no difference in stroke prevention between the two groups. Importantly, low-dose hydroxyurea was superior to no treatment for prevention of strokes in children with abnormal TCD values and sickle cell disease, suggesting that this treatment is promising as a lower cost alternative for chronic blood transfusion therapy for children with sickle cell disease in low-income and middle-income countries [10,11].…”
Section: Global Impact and Incidencementioning
confidence: 99%
“…These figures for incidence are all less than the expected rate of 10.7 strokes per 100 PYO in the untreated arm of the STOP trial [ 117 ] ( Figure 1 B). In a randomised trial comparing 10 mg/kg and 20 mg/kg fixed dose hydroxyurea, the incidence rates of stroke were also both lower than the untreated arm of the STOP study and were not significantly different from each other [ 125 , 126 ].…”
Section: Strokementioning
confidence: 99%
“…Included studies are Núñez et al[38], Sumoza et al[39], Bortolusso Ali et al[40], Mvalo et al[41], Cunningham-Myrie et al[42], Lefèvre et al[43], Abdullahi et al[44], Al Hawsawi and Turkistani[45], Ware et al[46], Darshana et al[26], and Abboud[27].…”
mentioning
confidence: 99%