ArticleBlood global hematology2025
Hydroxyurea to decrease stroke risk in children with sickle cell anemia: a systematic review and meta-analysis.
Article in Blood global hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
- Optimizing the right time to start sickle cell therapies.Hematology. American Society of Hematology. Education Program · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Sickle cell anemia (SCA) is an inherited hemolytic anemia that causes stroke in children. Transcranial Doppler ultrasound (TCD) of the intracerebral arteries quantifies primary stroke risk. Chronic blood transfusions reduce risk but are not always feasible in lower resource settings. Hydroxyurea decreases TCD velocities in SCA, but the effect size and duration are unclear. We conducted a systematic review to understand hydroxyurea's effectiveness in children. We searched 5 major medical databases (CINAHL, EMBASE, Trip Medical Database, Scopus, and PubMed) and identified prospective clinical trials that enrolled children with SCA, performed TCD screening before hydroxyurea treatment, and collected serial measurements of TCD velocities and stroke incidence during hydroxyurea treatment. Citations were screened for inclusion, eligible citations selected, and data extracted. A total of 104 reports describing 13 clinical trials with 592 participants were included in the review. Hydroxyurea decreased TCD with a mean decline of -30 cm/s (95% confidence interval, -41 to -19) over 0.5 to 2.6 years of therapy. The TCD velocity normalized in most children. Stroke was reported in 3 trials, only occurred in those with persistent abnormal TCD values (>200 cm/s), and had lower incidence than expected (0.52-1.92 per 100 patient-years). Hydroxyurea is an effective strategy for reducing TCD velocities and stroke risk in children with SCA and is a feasible alternative when transfusions are unavailable, especially in resource-limited settings. Additional research is needed to clarify the effect on stroke incidence and optimal dosing strategies for durable treatment effect, long-term safety, and comprehensive benefits in diverse health care settings.
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Registered trials
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