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Fármacos para la prevención de la deshidratación de los eritrocitos en personas con enfermedad de células falciformes

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Referencias

Referencias de los estudios incluidos en esta revisión

Ir a:

Gupta 1995 {published data only}

Gupta VL, Chaubey BS. Efficacy of zinc therapy in prevention of crisis in sickle cell anemia: a double blind, randomized controlled clinical trial. Journal of the Association of Physicians of India 1995;43(7):467‐9.

Referencias de los estudios excluidos de esta revisión

Ir a:

Adadevoh 1973 {published data only}

Adadevoh BK, Isaacs WA. The effect of megestrol acetate on sickling. American Journal of the Medical Sciences 1973;265(5):367‐70.

Adams‐Graves 1997 {published and unpublished data}

Adams‐Graves P, Kedar A, Koshy M, Steinberg M, Veith R, Ward D. Rheothrx (Poloxamer 188) injection for the acute painful episode of sickle cell disease (SCD): a pilot study [abstract]. Proceedings of the 30th Annual Meeting of the National Sickle Cell Disease Program; March 1995. 1995:118.
Adams‐Graves P, Kedar A, Koshy M, Steinberg M, Veith R, Ward D, et al. RheothRx (Poloxamer 188) injection for the acute painful episode of sickle cell disease: a pilot study. Blood 1997;90(5):2041‐6.
Adams‐Graves P, Mauer A. RheothRx® (poloxamer 188) injection for the acute painful episode of sickle cell disease. Blood 1994;84(Suppl):410a.
Emanuele M, Adams‐Graves P, Kedar A, Koshy M, Steinberg R, Veith R, et al. RheothRx (Poloxamer 188) lowers serum LDH during an acute painful episode of sickle cell disease [abstract]. Blood 1996;88(10 (Suppl 1)):13a.

Al‐Jam'a 1999 {published data only}

Al‐Jam'a AH, Al‐Dabbous IA, Rafiq MS, Al‐Khatti A, Al‐Salem AH, Al‐Baharna A, et al. Isoxsuprine in the treatment of sickle cell painful crises: a double‐blind comparative study with narcotic analgesia. Annals of Saudi Medicine 1999;19(2):97‐100.

Alvim 2005 {published data only}

Alvim RC, Viana MB, Pires MA, Franklin HM, Paula MJ, Brito AC, et al. Inefficacy of piracetam in the prevention of painful crises in children and adolescents with sickle cell disease. Acta Haematologica 2005;113(4):228‐33.

Ataga 2002 {published data only}

Ataga KI, Orringer EP, Styles L, Vichinsky E, Swerdlow P, Davis GA, et al. A phase 1B randomized, double‐blind, placebo‐controlled, single‐dose, dose‐escalation study of IC 17043 in patients with sickle cell disease (SCD) [abstract]. Proceedings of the 30th Annual Meeting of the National Sickle Cell Disease Program. 2002:41a.
Ataga KI, Orringer EP, Styles L, Vichinsky E, Swerdlow P, Davis GA, et al. A phase 1B randomized, double‐blind, placebo‐controlled, single‐dose, dose‐escalation study of ICA‐17043 in patients with sickle cell disease (SCD) [abstract]. Blood 2002;100(11 (Part 1 of 2)):454a.

Ayra 1996 {published data only}

Arya R, Rolan PE, Wootton R, Posner J, Bellingham AJ. Tucaresol increases oxygen affinity and reduces haemolysis in subjects with sickle cell anaemia. British Journal of Haematology 1996;93(4):817‐21.

Benjamin 1986 {published data only}

Benjamin LJ, Berkowitz LR, Orringer E, Mankad VN, Prasad AS, Lewkow LM, et al. A collaberative, double‐blind randomized study of cetiedil citrate in sickle cell crisis. Blood 1986;67(5):1442‐7.

Billet 1989 {published data only}

Billett HH, Kaul DK, Connel MM, Fabry ME, Nagel RL. Pentoxifylline (Trental) has no significant effect on laboratory parameters in sickle cell disease. Nouvelle Revue Francaise d'Hematologie 1989;31(6):403‐7.

Cabannes 1983 {published data only}

Cabannes R, Sangare A, Cho YW. Acute painful sickle‐cell crises in children: a double‐blind, placebo‐controlled evaluation of efficacy and safety of cetiedil. Clinical Trials Journal 1983;20(4):207‐18.

Cabannes 1984 {published data only}

Cabannes R, Lonsdorfer J, Castaigne JP, Ondo A, Plassard A, Zohoun I. Clinical and biological double‐blind‐study of Ticlopidine in preventive treatment of sickle cell disease crises. Agents and Actions Supplements 1984;15:199‐212.

De Abood 1997 {published data only}

De Abood M, de Castillo Z, Guerrero F, Espino M, Austin KL. Effect of Depo‐Provera® or Microgynon® on the painful crises of sickle cell anemia patients. Contraception 1997;56(5):313‐6.

De Ceulaer 1982 {published data only}

De Ceulaer K, Gruber C, Hayes R, Serjeant GR. Medroxyprogesterone acetate and homozygous sickle cell disease. Lancet 1982;2(8292):229‐31.
De Ceulaer K, Gruber C, Serjeant G. Effect of depo‐provera on the haematological and clinical features of homozygous sickle cell disease [abstract]. Proceedings of the Commonwealth Caribbean Medical Research Council, 27th Scientific Meeting; 1982 April 14‐17; Trinidad and Tobago. 1982:47.

De Ceulaer 1990 {published data only}

De Ceulaer K, Serjeant GR, Nagel RL, Billett HH, Christakis J, Loukopoulos D, et al. Intravenous oxypentifylline and the painful crisis of sickle cell disease. Clinical Hemorheology 1990;10(1):35‐42.

Gail 1982 {published data only}

Gail M, Beach J, Dark A, Lewis R, Morrow H. A double‐blind randomized trial of low‐dose urea to prevent sickle cell crises. Journal of Chronic Diseases 1982;35(2):151‐61.

Godeau 2003 {unpublished data only}

Godeau B, Roudet‐Thoraval F, Havivi A, Elmur T, Bachir D, Paul M, et al. Assessment of ketoprofen for acute vaso‐occlusive crisis in adult patients with sickle cell disease. A randomized double blind monocentric study. Blood. 2003; Vol. 102, issue 11:2824a.

Isaacs 1971 {published data only}

Isaacs WA. The effect of certain lipid substances on sickling. Acta Haematologica 1971;45(4):259‐65.
Isaacs WA, Effiong CE, Ayeni O. Steroid treatment in the prevention of painful episodes in sickle‐cell disease. Lancet 1972;1(7750):570‐1.

Jacobson 1997 {published and unpublished data}

Jacobson SJ, Kopecky EA, Joshi P, Babul N. Randomised trial of oral morphine for painful episodes of sickle‐cell disease in children. Lancet 1997;350(9088):1358‐61.
Kopesky EA, Jacobson S, Joshi P, Koren G. Systemic exposure to morphine and the risk of acute chest syndrome in sickle cell disease. Clinical Pharmacology and Therapeutics 2004;75(3):140‐6.

Lonsdorfer 1984 {published data only}

Lonsdorfer J, Castaigne JP, Lenormand E, Otayeck A, Bogui P, Dosso Y, et al. Beneficial effects of Ticlopidine on cardiopulmonary function of sickle cell patients not in crisis. Agents and Actions Supplements 1984;15:213‐8.

Mahmood 1969 {published data only}

Mahmood A. A double‐blind trial of a phenothiazine compound in the treatment of clinical crisis of sickle cell anaemia. British Journal of Haematology 1969;16(1):181‐4.

Manion 2001 {published data only}

Manion C, Parkhurst JB, Ogle B, Johnson A, Edmundson A. Aspartame inhibits hypoxia‐induced sickling of erythrocytes in patients with sickle cell disease [abstract]. Proceedings of the 24th Annual Meeting of the National Sickle Cell Disease Program. 2000:172a.
Manion CV, Howard J, Ogle B, Parkhurst J, Edmundson A. Aspartame effect in sickle cell anemia. Clinical Pharmacology and Therapeutics 2001;69(5):346‐55.

Manrique 1987 {published data only}

Manrique RV. Placebo controlled double‐blind study of pentoxifylline in sickle cell disease patients. Journal of Medicine 1987;18(5&6):277‐91.

Orringer 1991 {published data only}

Orringer E, Huffman J, Johnson A, Jones S, Whitney J, Brockenbrough S, et al. A clinical study of the safety, pharmacokinetics and pharmacodynamics of intravenous infusions of 12C79 in sickle cell disease patients not in crisis [abstract]. Proceedings of the 16th Annual Meeting of the National Sickle cell Disease Program. March 1991:112.
Orringer EP, Binder EA, Thomas RP, Blythe DS, Bustrack JA, Schroeder DH, et al. Phase 1 study of BW 12C in sickle cell disease (SCD) patients not in crisis [abstract]. Blood 1988;5(Suppl 1):69a.
Orringer EP, Binder EA, Thomas RP, Blythe DS, Bustrack JA, Schroeder DH, et al. Phase I study of 12C79 in sickle cell disease (SCD) patients not in crisis [abstract]. Proceedings of the 14th Annual Meeting of the National Sickle Cell Disease Program. 1989:57.

Osamo 1981 {published data only}

Osamo NO, Photiades DP, Famodu AA. Therapeutic effect of aspirin in sickle cell anaemia. Acta Haematologica 1981;66(2):102‐7.

Oski 1968 {published data only}

Oski F, Call FL, Lessen L. Failure of promazine HCl to prevent the painful episodes in sickle cell anemia. Journal of Pediatrics 1968;73(2):265‐6.

Oyewo 1987 {published data only}

Oyewo EA. Therapeutic effect of diflusinal as prophylaxis in sickle cell anaemia. Clinical Trials Journal 1987;24(3):249‐53.

Pace 2003 {published data only}

Pace BS, Shartava A, Pack‐Mabien A, Mulekar M, Ardia A, Goodman SR. Effects of N‐acetylcysteine on dense cell formation in sickle cell disease. American Journal of Hematology 2003;73(1):26‐32.

Pichard 1987 {published data only}

Pichard E, Duflo B, Coulibaly S, Mariko B, Monsempes JL, Traore HA, et al. Effectiveness of treatment during osteoarticular pain crises in drepanocytosis; based on the example of pentoxifylline [Evaluation de L'efficacite des traitements au cours des crises douloureuses osteo‐articulaires de la drepanocytose exemple de la pentoxifylline]. Bulletin de la Societe de Pathologie Exotique et de ses Filiales (Paris) 1987;80(5):834‐40.

Piracetam Study 1998 {published data only}

El‐Hazmi AF, Warsy AS, Al‐Fawaz I, Farid M, Refai S, Opawoye AD, et al. Piracetam in the treatment of sickle cell disease [abstract. Proceedings of the 20th Annual Meeting of the National Sickle Cell Disease Program. 1995:162a.
El‐Hazmi MAF, Warsy AS, Al‐Fawaz I, Opawoye AD, Abu Taleb H, Howsawi Z, et al. Piracetam is useful in the treatment of children with sickle cell disease. Acta Haematologica 1996;96(4):221‐6.
The Piracetam Study Group. Piracetam for the treatment of sickle cell disease in children ‐ a double blind test. Saudi Medical Journal 1998;19(1):22‐7.

Poflee 1991 {published data only}

Poflee VW, Gupta OP, Jain AP, Jajoo UN. Haemorheological treatment of painful sickle cell crises: use of pentoxifylline. Journal of the Association of Physicians India 1991;39(8):608‐9.

Rubio 1992 {published data only}

Rubio A, Cox C, Weintraub M. Prediction of diltiazem plasma concentration curves from limited measurements using compliance data. Clinical Pharmacokinetics 1992;22(3):238‐46.
Rubio A, Weintraub M. Scoring system in a pilot effectiveness study of patients with sickle cell anemia. Journal of Clinical Research and Pharmacoepidemiology 1992;6:47‐54.

Semple 1984 {published data only}

Semple MJ, Al‐Hasani SF, Kioy P, Savidge GF. A double‐blind trial of Ticlopidine in sickle cell disease. Thrombosis and Haemostasis 1984;51(3):303‐6.

Teuscher 1988 {published data only}

Teuscher T, Weil Von Der Ahe C, Baillod P, Holzer B. Double blind randomised clinical trial of pentoxiphyllin in vaso‐occlusive sickle cell crisis. Tropical and Geographical Medicine 1989;41(4):320‐5.

Toppet 2000 {published data only}

Toppet M, Fall ABK, Ferster A, Fondu P, Melot C, Vanhaelen‐Fastre R, et al. Antisickling activity of sodium cromoglicate in sickle‐cell disease [letter]. Lancet 2000;356(9226):309.

Urea Trial 1974 {published data only}

Cooperative Urea Trials Group. Clinical trials of therapy for sickle cell vaso‐occlusive crises. Journal of the American Medical Association 1974;228(9):1120‐4.

Urea Trial 2 1974 {published data only}

Cooperative Urea Trials Group. Treatment of sickle cell crisis with urea in invert sugar. A controlled trial.. Journal of the American Medical Association 1974;228(9):1125‐8.

Urea Trial 3 1974 {published data only}

Cooperative Urea Trials Group. Controlled clinical trials and cooperative study of intravenously administered alkali. Journal of the American Medical Association 1974;228(9):1129‐31.

Wambebe 2001 {published data only}

Fonnebo V. Indigenous Nigerian medicinal plants may be useful in the management of sickle‐cell disorder. Focus on Alternative and Complementary Therapies 2002;7(2):146.
Wambebe C. Chemistry and clinical evaluation of NIPRISAN in patients with sickle cell anemia [abstract]. Proceedings of the 30th Annual Meeting of the National Sickle Cell Disease Program. 2002:46a.
Wambebe C, Khamofu H, Momoh JAF, Ekpeyong M, Audu BS, Njoku OS, et al. Double‐blind, placebo‐controlled, randomised cross‐over clinical trial of Niprisan in patients with sickle cell disorder. Phytomedicine 2001;8(4):252‐61.
Wambebe CO, Bamgboye EA, Badru BO, Khamofu H, Momoh JA, Ekpeyong M, et al. Efficacy of niprisan in the prophylactic management of patients with sickle cell disease. Current Therapeutic Research, Clinical and Experimental 2001;62(1):26‐34.

Zago 1984 {published data only}

Zago MA, Costa FF, Ismael SJ, Tone LG, Bottura C. Treatment of sickle cell diseases wih aspirin. Acta Haematologica 1984;72(1):61‐4.

Nodaros 1999 {published data only}

Nodaros K, Voskaridou E, Atta‐Polotos J, Loukopoulos D. Administration of magnesium aspartate in patients with HbS/B‐Thalassemia normalizes the RBC density distribution and removes dense sickle cells from the peripheral blood [abstract]. Blood 1999;94(10, Suppl 1, Part 1):200a.
Voskaridou E, Nodaros K, Atta‐Politis J, Loutradi A, Loukopoulos D. Administration of magnesium aspartate in patients with HbS/b‐Thalassaemia results in normalization of the red cell density distribution curves and removal of the dense sickle cells from the peripheral blood [abstract]. Proceedings of the 5th Congress of the European Haematology Association (EHA); 2000 June 25‐28; Birmingham, UK. 2000.

Adrie 2000

Adrie C, Kister J, De Franceschi L, Rouyer‐Fessard P, Kieger L, Marden M, et al. Nitric oxide restores the erythrocyte density of the SAD mouse model of sickle cell disease [abstract]. Blood 2000;96(11):Parts 1 and 2.

Al Hajeri 2007

Al Hajeri AA, Fedorowicz Z, Omran A, Tadmouri GO. Piracetam for reducing the incidence of painful sickle cell disease crises. Cochrane Database of Systematic Reviews 2007, Issue 2. [DOI: 10.1002/14651858]

Ballas 1989

Ballas SK, Dover GJ, Charache S. Effect of hydroxyurea on the rheological properties of sickle erythrocytes in vivo. American Journal of Hematology 1989;32(2):104‐11.

Ballas 2000

Ballas SK. Hydration of sickle erythrocytes using a naturally occurring sodium ionophore [abstract]. Blood 2000;96(11):Parts 1 and 2.

Bennekou 2000

Bennekou P, Pederson O, Moller A, Christopherses P. Volume control in sickle cells is facilitated by novel anion conductance inhibitor NS1652. Blood 2000;95(5):1842‐8.

Bennekou 2001

Bennekou P, de Franceschi L, Pedersen O, Lian L, Asakura T, Evans G, et al. Treatment with NS3623, a novel Cl‐conductance blocker, amiliorates erythrocyte dehydration in transgenic SAD mice: a possible new therapeutic approach for sickle cell disease. Blood 2001;97(5):1451‐7.

Brugnara 1987

Brugnara C, Tosteson DC. Inhibition of K transport by divalent cations in sickle erythrocytes. Blood 1987;70(6):1810‐5.

Brugnara 1993

Brugnara C, De Franceschi L, Alper SL. Inhibition of Ca2+activated K + transport and cell dehydration in sickle erythrocytes by clotrimazole and other imidazole derivatives. Journal of Clinical Investigation 1993;92(1):520‐6.

Brugnara 1995

Brugnara C. Red cell dehydration in pathophysiology and treatment of sickle cell disease. Current Opinion in Hematology 1995;2(2):132‐8.

Brugnara 1996

Brugnara C, Gee B, Armsby CC, Kurth S, Sakamoto M, Rifai N, et al. Therapy with oral clotrimazole induces inhibition of the Gardos channel and reduction of erythrocyte dehydration in patients with sickle cell disease. Journal of Clinical Investigation 1996;97(5):1227‐34.

Charache 1995

Charache S, Terrin M, Moore R, Dover G, Barton F, Eckert S, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. New England Journal of Medicine 1995;332(20):1317‐22.

Davies 1997

Davies SC, Oni L. Management of patients with sickle cell disease. BMJ 1997;315(7109):656‐60.

de Franceschi 1994

de Franceschi L, Saadane N, Trudel M, Alper S L, Brugnara C, Beuzard Y. Treatment with oral clotrimazole blocks Ca(2+)‐activated K+ transport and reverses erythrocyte dehydration in transgenic SAD mice. A model for therapy of sickle cell disease.. Journal of Clinical Investigation 1994;93(4):1670‐6.

de Franceschi 1997

de Franceschi L, Bachir D, Galacteros F, Tchernia G, Cynober T, Alper S, et al. Oral magnesium supplements reduce erythrocyte dehydration in patients with sickle cell disease. Journal of Clinical Investigation 1997;100(7):1847‐52.

Gibson 1998

Gibson X A, Shartava A, McIntyre J, Monteiro C A, Zhang Y, Shah A, et al. The efficacy of reducing agents or antioxidants in blocking the formation of dense cells and irreversibly sickled cells in vitro. Blood 1998;91(11):4373‐8.

Gibson 2000

Gibson JS, Stewart GW, Ellory JC. Effect of dimethyl adipimidate on K+ transport and shape change in red blood cells from sickle cell patients. FEBS Letters 2000;480(2‐3):179‐83.

Gini 1987

Gini EK, Sonnet J. Use of piracetam improves sickle cell deformability in vitro and in vivo. Journal of Clinical Pathology 1987;40(1):99‐102.

Gupta 1987

Gupta VL, Chaubey BS. Red blood cell survival, zinc deficiency and efficacy of zinc therapy in sickle cell disease. In: Fucharoen S, Rowley PT, Paul NW editor(s). Thalassemia: pathophysiology and management, part A. Vol. 23, New York: Alan R Liss Inc, 1987:477‐83.

Hickman 1999

Hickman M, Modell B, Greengross P, Chapman C, Layton M, Falconer S, et al. Mapping the prevalence of sickle cell disease and beta thalassaemia in England: estimating and validating ethnic‐specific rates. British Journal of Haematology 1999;104(4):860‐7.

Jones 2001

Jones AP, Davies SC, Olujohungbe A. Hydroxyurea for sickle cell disease. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858]

Karayalcin 1974

Karayalcin G, Rosner F, Kim KY, Chandra P. Plasma‐zinc in sickle cell‐anaemia [letter]. Lancet 1974;1(7850):217.

Leikin 1989

Leikin SL, Gallagher D, Kinney TR, Sloane D, Klug P, Rida W. Mortality in children and adolescents with sickle cell disease. Pediatrics 1989;84(3):500‐8.

Prasad 1981

Prasad AS, Abbasi AA, Rabbani P, DuMouchelle E. Effect of zinc supplementation on serum testosterone level in adult male sickle cell anemia subjects. American Journal of Hematology 1981;10(2):119‐27.

Prasad 1999

Prasad AS, Beck FWJ, Kaplan J, Chandrasekar PH, Ortega J, Fitzgerald JT, et al. Effect of zinc supplementation on incidence of infections and hospital admissions in sickle cell disease (SCD). American Journal of Hematology 1999;61(3):194‐202.

Qureshi 2000

Qureshi MA, Gugnani MK, Swerdlow PS, Girgis RE. Decreased exhaled nitric oxide (NO) in patients with sickle cell disease [abstract]. Blood 2000;96(11 (Pt 1 and 2)).

Rivera 2000

Rivera A, Brugnara C. Vaso‐active molecules modulate Gardos channel activity and hydration state of normal and sickle erythrocytes. Blood. 2000; Vol. 96, issue 11 (Pt 1 and 2).

Romero 2000

Romero JR, Suzuka SM, Nagel RL, Fabry ME. Arginine supplementation of sickle transgenic mice: effects on red cell density and potassium transport [abstract]. Blood 2000;96(11 (Pt 1 and 2)).

Romero 2002

Romero JR, Suzuka SM, Nagel RL, Fabry ME. Arginine supplementation of sickle transgenic mice reduces red cell density and Gardos channel activity. Blood 2002;99(4):1103‐8.

Serjeant 1970

Serjeant GR, Galloway RE, Gueri MC. Oral zinc sulphate in sickle‐cell ulcers. Lancet 1970;2(7679):891‐2.

Serjeant 1992

Serjeant GR. Sickle cell disease. 2nd Edition. New York: Oxford Medical Publications, 1992.

Stocker 2000

Stocker J, De Franceschi L, McNaughton‐Smith G, Brugnara C. A novel Gardos channel inhibitor, ICA‐17043, prevents red blood cell dehydration in vitro and in a mouse model (SAD) of sickle cell disease [abstract]. Blood 2000;96(11 (Pt 1 and 2)).

Stone 1988

Stone PCW, Chalder SM, Stuart J. Action of piracetam on cation flux and deformability of sickle cells. Clinical Hemorheology 1988;8(5):779‐90.

Stuart 1990

Stuart J, Stone PCW, Nash GB, Ellory JC. Effect of Piracetam on Ca2+‐induced K+ efflux from sickle cells. Clinical Hemorheology 1990;10(5):535‐40.

Stuart 1992

Stuart J. Rheological consequences of sickle‐cell dehydration. Clinical Hemorheology 1992;12(2):203‐16.

Zemel 2001

Zemel B, Kawchak D, Fung E, Ohene‐Frempong K, Stallings V. Zinc supplementation and linear growth in children with sickle cell disease: a pilot study [abstract]. Proceedings of the 25th Annual Meting of the National Sickle Cell Disease Program; April 2001; New York. 2001:Abst #232.

Referencias de otras versiones publicadas de esta revisión

Ir a:

Riddington 2002

Riddington C, De Franceschi L. Drugs for preventing red blood cell dehydration in people with sickle cell disease. Cochrane Database of Systematic Reviews 2002, Issue 4. [DOI: 10.1002/14651858]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Gupta 1995

Methods

Double‐blind, placebo‐controlled, randomised controlled trial.

Participants

145 participants from India with SS disease, aged over 5 years. 15 participants were lost to follow up.

Interventions

Zinc (oral 220 mg tds) or placebo (identical in appearance). Participants were seen weekly, follow up was for 1.5 years and the data were analysed at the end of the follow‐up period.

Outcomes

Sickle related crises: vaso‐occlusive; mixed; haemolytic; sequestration; and aplastic. Days in hospital and working days lost.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment?

Unclear risk

Unclear

IV: intravenous
SCD: sickle cell disease
SS: sickle cell anaemia
tds: three times daily

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Adadevoh 1973

RCT of megestrol acetate. There is no good recent evidence to suggest that sex hormones prevent dehydration of the sickle red cells.

Adams‐Graves 1997

Trial of poloxamer 188 ‐ inappropriate mechanism of action for inclusion in this review.

Al‐Jam'a 1999

Trial of isoxsurpine in treatment of sickle cell crises ‐ rather than prevention.

Alvim 2005

RCT of piracetam. There is a lack of evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the cell membrane.

Ataga 2002

Pharmacokinetic study of ICA 17043, with no measure of clinical outcomes of interest.

Ayra 1996

RCT of tucaresol. Prevents sickling by shifting the oxygen affinity, not through red cell dehydration.

Benjamin 1986

RCT of cetiedil citrate. Used in treatment rather than prevention of crises.

Billet 1989

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the red cell membrane.

Cabannes 1983

RCT of cetiedil citrate. Used in treatment rather than prevention of crises.

Cabannes 1984

RCT of ticlopidine. Mainly an inhibitor of platelet action, rather than anti‐dehydration.

De Abood 1997

RCT of Depo‐Provera and Microgynon. There is no good evidence to suggest that sex hormones prevent dehydration of the sickle red cells.

De Ceulaer 1982

RCT of medroxyprogesterone acetate. There is no good recent evidence to suggest that sex hormones prevent dehydration of the sickle red cells

De Ceulaer 1990

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the red cell membrane.

Gail 1982

RCT of urea. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

Godeau 2003

RCT of ketoprofen for treatment, rather than prevention, of vaso‐occlusive crises.

Isaacs 1971

RCT of steroids. There is no good recent evidence to suggest that sex hormones prevent dehydration of the sickle red cells.

Jacobson 1997

Risk analysis using data from a previous RCT, in which morphine was administered in treatment, rather than prevention, of acute chest syndrome.

Lonsdorfer 1984

RCT of ticlopidine. Mainly an inhibitor of platelet action, rather than anti‐dehydration.

Mahmood 1969

RCT of a phenothiazine. Used in treatment rather than prevention of crises.

Manion 2001

Pharmacokinetic study of aspartame, with no measure of outcomes of interest.

Manrique 1987

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the red cell membrane.

Orringer 1991

RCT of 12C79, which prevents sickling primarily by increasing oxygen affinity, with possible secondary effects on the potassium‐chloride co‐transport channels in the red cell membrane.

Osamo 1981

Trial of aspirin. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

Oski 1968

Study not randomised, looks at promazine chloride.

Oyewo 1987

Study of diflusinal, anti‐sickling effects not due to red cell dehydration.

Pace 2003

Phase II RCT of N‐Acetylcysteine for prevention of sickle cell related vaso‐occlusion and formation of dense cells. There is insufficient evidence that N‐Acetylcysteine acts via red cell dehydration to include this study in the review.

Pichard 1987

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the cell membrane.

Piracetam Study 1998

RCT of piracetam. There is a lack of evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the cell membrane.

Poflee 1991

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the cell membrane.

Rubio 1992

Pharmacokinetic study of diltiazem, with no measure of outcomes of interest.

Semple 1984

RCT of ticlopidine. Mainly an inhibitor of platelet action, rather than anti‐dehydration.

Teuscher 1988

RCT of pentoxifylline. There is no evidence that the anti‐sickling effect of the drug is due to a reduction in water loss through the cell membrane.

Toppet 2000

Non‐randomised ex‐vivo study of sodium cromoglicate, an anti‐sickling agent, majority of patients also taking hydroxyurea.

Urea Trial 1974

RCT of urea. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

Urea Trial 2 1974

RCT of urea. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

Urea Trial 3 1974

RCT of urea. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

Wambebe 2001

RCT of Niprisan, a naturally occurring compound. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of red cells.

Zago 1984

Trial of aspirin. There is no evidence that any anti‐sickling action is due to a reduction in dehydration of the sickle red cells.

RCT: randomised controlled trial

Characteristics of ongoing studies [ordered by study ID]

Ir a:

Nodaros 1999

Trial name or title

Administration of magnesium aspartate in people with HbS/b‐Thal.

Methods

Participants

Adults with sickle cell disease or beta‐thalassaemia in Greece.

Interventions

Magnesium (aspartate).

Outcomes

RBC magnesium, mean cell haemoglobin concentration, reticulocytes, dense red blood cells.

Starting date

1999

Contact information

Thalassaemia Unit, First Department of Medicine, University of Athens, Laikon Hospital, Athens, Greece.

Notes

RBC: red blood cell

Data and analyses

Open in table viewer
Comparison 1. Anti‐sickling drug versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.1
Comparison 1 Anti‐sickling drug versus placebo, Outcome 1 Mortality.

Comparison 1 Anti‐sickling drug versus placebo, Outcome 1 Mortality.

2 Number of pain crises

0

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3 Number of other serious sickle‐related complications Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.3
Comparison 1 Anti‐sickling drug versus placebo, Outcome 3 Number of other serious sickle‐related complications.

Comparison 1 Anti‐sickling drug versus placebo, Outcome 3 Number of other serious sickle‐related complications.

3.1 Overall

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Red cell dehydration

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 Mean cell volume

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 Mean cell haemoglobin concentration

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Full blood count (1)

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 Haemoglobin (g/dl)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 HbF (%)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Full blood count (2)

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 White blood cell count (x10e9/l)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Quality of life measures Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.7
Comparison 1 Anti‐sickling drug versus placebo, Outcome 7 Quality of life measures.

Comparison 1 Anti‐sickling drug versus placebo, Outcome 7 Quality of life measures.

7.1 Hospital stay per crisis (days)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 Loss of work days/crisis

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 Number of hospitalisations per year

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Other sickle related events

0

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

9 Adverse drug reactions

0

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

Comparison 1 Anti‐sickling drug versus placebo, Outcome 1 Mortality.
Figuras y tablas -
Analysis 1.1

Comparison 1 Anti‐sickling drug versus placebo, Outcome 1 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Anti‐sickling drug versus placebo, Outcome 3 Number of other serious sickle‐related complications.
Figuras y tablas -
Analysis 1.3

Comparison 1 Anti‐sickling drug versus placebo, Outcome 3 Number of other serious sickle‐related complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Anti‐sickling drug versus placebo, Outcome 7 Quality of life measures.
Figuras y tablas -
Analysis 1.7

Comparison 1 Anti‐sickling drug versus placebo, Outcome 7 Quality of life measures.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Comparison 1. Anti‐sickling drug versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Number of pain crises

0

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3 Number of other serious sickle‐related complications Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 Overall

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Red cell dehydration

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 Mean cell volume

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 Mean cell haemoglobin concentration

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Full blood count (1)

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 Haemoglobin (g/dl)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 HbF (%)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Full blood count (2)

0

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 White blood cell count (x10e9/l)

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Quality of life measures Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

7.1 Hospital stay per crisis (days)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 Loss of work days/crisis

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 Number of hospitalisations per year

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Other sickle related events

0

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

9 Adverse drug reactions

0

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Anti‐sickling drug versus placebo
Ir a la tabla de la revisión