Hydroxyurea efficacy in sickle cell anemia patients in low-income middle country in Cote d’Ivoire

Abstract Background. Very few studies have been set in Subsaharan Africa according to hydroxyurea effacy and safety. We aimed to evaluate Hydroxyurea efficacy and safety and its benefits in low-resource settings. Methods We conducted a prospective comparative study of SCA patients. 128 patients was enrolled and divided in two groups. 68 patients treated by hydroxyurea at doses 10-20mg/kg/day and 62 patients control groups without hydroxyurea. The end points assessed was feasibility, safety, and benefits (laboratory variables, sickle cell–related events, transfusions). Results : The patients assigned to hydroxyurea treatment had lower annual rate of crises than the control group (median, 2.9 vs. 5.3 crises per year, P=0.001), fewer annual rate of hospitalizations (median 2.2 vs. 4.7, P=0.002), and fewer annual rate of transfusion (median 1.3 vs.5.1, P=0.001). We observed a significant increase in Hb F level from 11.77% to 14.6% (p=0.001) in patient treated by hydroxyurea. We also observed a significant increase in the mean of Hb level from 7.3 g/dl to 9.2 g/dl for patients treated by hydroxyurea (p=0.004). Patients treated by hydroxyurea also have a beneficial effect on WBC and platelet levels by reduction in leukocytosis and thrombocytosis. the occurrence of annual number of infectious complications was significantly lower in the group of patients with hydroxyurea. Conclusion: Hydroxyurea has a key clinical benefits by reducing the incidence of vaso-occlusive events, infections, transfusions, which translates into fewer hospitalizations. The main problem is the fact that, it’s not accessible for most of our patients who live in poor socio-economical condition.