Evidence map›Paper›PMID 32673439›Full record

ArticleJournal of clinical pharmacology2021

Computer Algorithm-Based Hydroxyurea Dosing Facilitates Titration to Maximum Tolerated Dose in Sickle Cell Anemia.

Mahogany Oldham, Anna Conrey, Corinne Pittman, Cameron Fisher, Simone Hargrett, Kamille West, Mary Jackson, Staci Martin, Matthew M Hsieh, Neal Jeffries and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical pharmacology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Mahogany OldhamSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Anna ConreySickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Corinne PittmanSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Cameron FisherSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Simone HargrettSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Kamille WestDepartment of Transfusion Medicine, Clinical Center, NIH, Bethesda, Maryland, USA.
Mary JacksonSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Staci MartinPediatric Oncology Branch, NCI, NIH, Bethesda, Maryland, USA.
Matthew M HsiehSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.
Neal JeffriesOffice of Biostatistics Research, NHLBI, NIH, Bethesda, Maryland, USA.
Mihailo KaplarevicOffice of the Scientific Director, NHLBI, NIH, Bethesda, Maryland, USA.
Dachelle JohnsonPharmacy Department, Clinical Center, NIH, Bethesda, Maryland, USA.
Purevdorj OlkhanudSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.ORCID 0000-0002-3336-376X
Courtney D FitzhughSickle Cell Branch, NHLBI, NIH, Bethesda, Maryland, USA.ORCID 0000-0002-5306-7167
National Institutes of Health · USNational Institutes of Health Clinical Center · USOffice of the Director · US

Funding

Nitric Oxide and Endothelial Function in Patients with MalariaZIAAI001150 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI ACKERMAN, HANS · 2011 to 2025
$19.4M
Intramural NIH HHS Z99 HL999999
6 · The paper itself

Abstract

Adults with sickle cell disease (SCD) experience acute and chronic complications and die prematurely. When taken at maximum tolerated dose (MTD), hydroxyurea prolongs survival; however, it has not consistently reversed organ dysfunction. Patients also frequently do not take hydroxyurea, at least in part because of physician discomfort with prescribing hydroxyurea. We sought to develop a computer program that could easily titrate hydroxyurea to MTD. This was a single-arm, open-label pilot study. Fifteen patients with homozygous SCD were enrolled in the protocol, and 10 patients were followed at baseline and then for 1 year after hydroxyurea initiation or dose titration. Fetal hemoglobin significantly increased in all 10 patients from 8.3% to 25.1% (P < .001). Nine patients were titrated to MTD in an average of 7.9 months, and the tenth patient's hydroxyurea dose was increased to 33 mg/kg/day. Computer program dosing recommendations were the same as manual dosing decisions made using the same algorithm for all patients and at all times. We also evaluated markers of cardiopulmonary, liver and renal damage. Although cardiopulmonary function did not significantly improve, direct bilirubin and alanine aminotransferase levels significantly decreased (P < .001 and P < .01, respectively). Last, although kidney function did not improve, degree of proteinuria was significantly reduced (P < .05). We have developed a computer program that reliably titrates hydroxyurea to MTD. A larger study is indicated to test the program either as a computer program or a downloadable application.

Indexed as

AdultAlgorithmsAnemia, Sickle CellAntisickling AgentsDose-Response Relationship, DrugFemaleHemodynamicsHemoglobinsHumansHydroxyureaKidney Function TestsLiver Function TestsMaleMaximum Tolerated DoseMiddle AgedPilot ProjectsAntisickling AgentsHemoglobinsHydroxyureacomputer programhydroxyureamaximum tolerated doseorgan damagesickle cell disease

Identifiers

PMID32673439
PMCPMC8558836
OpenAlexW3042381752

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.