Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review
Inconsistent therapeutic responses have been observed among patients with sickle cell anemia (SCA) undergoing hydroxyurea (HU) following the adoption of the standardized protocol. Moreover, this treatment regimen necessitates a prolonged period to reach the maximum tolerated dose in which beneficial...
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MDPI AG
2023-06-01
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| Online Access: | https://www.mdpi.com/1424-8247/16/6/857 |
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| author | Joelma Santana dos Santos Neres Sètondji Cocou Modeste Alexandre Yahouédéhou Marilda Souza Goncalves |
| author_facet | Joelma Santana dos Santos Neres Sètondji Cocou Modeste Alexandre Yahouédéhou Marilda Souza Goncalves |
| author_sort | Joelma Santana dos Santos Neres |
| collection | DOAJ |
| description | Inconsistent therapeutic responses have been observed among patients with sickle cell anemia (SCA) undergoing hydroxyurea (HU) following the adoption of the standardized protocol. Moreover, this treatment regimen necessitates a prolonged period to reach the maximum tolerated dose in which beneficial therapeutic effects are observed in most SCA patients. To overcome this limitation, several studies have performed HU dose adjustments in SCA patients based on individualized pharmacokinetic profiles. The present systematic mini-review aims to select and analyze published data to present an overview of HU pharmacokinetics studies performed in SCA patients, as well as evaluate the effectiveness of the dose adjustment strategy. A systematic search was performed in the Embase, Pubmed, Scopus, Web of Science, Scielo, Google Scholar, and the Virtual Library of Health databases from December 2020 to August 2022, with a total of five studies included. Inclusion criteria consisted of studies in which the dose adjustment was performed in SCA patients based on pharmacokinetic parameters. Quality analyzes were performed using QAT, while data synthesis was performed according to the Cochrane Manual of Systematic Reviews of Interventions. Analysis of the selected studies revealed improved HU treatment effectiveness using personalized dosages in SCA patients. Moreover, several laboratory parameters were utilized as biomarkers of the HU response, and methods designed to simplify the adoption of this practice were presented. Despite the scarcity of studies on this topic, HU-personalized treatment based on individualized pharmacokinetic profiles represents a viable alternative for SCA patients who are candidates for HU therapy, especially for pediatric patients. Registration number: PROSPERO CRD42022344512. |
| first_indexed | 2024-03-11T02:03:23Z |
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| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-11T02:03:23Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
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| series | Pharmaceuticals |
| spelling | doaj.art-982c6b2130074231b328d2832e8e09142023-11-18T12:02:30ZengMDPI AGPharmaceuticals1424-82472023-06-0116685710.3390/ph16060857Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-ReviewJoelma Santana dos Santos Neres0Sètondji Cocou Modeste Alexandre Yahouédéhou1Marilda Souza Goncalves2Laboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fiocruz-BA, Salvador 40296-710, BrazilLaboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fiocruz-BA, Salvador 40296-710, BrazilLaboratório de Investigação em Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fiocruz-BA, Salvador 40296-710, BrazilInconsistent therapeutic responses have been observed among patients with sickle cell anemia (SCA) undergoing hydroxyurea (HU) following the adoption of the standardized protocol. Moreover, this treatment regimen necessitates a prolonged period to reach the maximum tolerated dose in which beneficial therapeutic effects are observed in most SCA patients. To overcome this limitation, several studies have performed HU dose adjustments in SCA patients based on individualized pharmacokinetic profiles. The present systematic mini-review aims to select and analyze published data to present an overview of HU pharmacokinetics studies performed in SCA patients, as well as evaluate the effectiveness of the dose adjustment strategy. A systematic search was performed in the Embase, Pubmed, Scopus, Web of Science, Scielo, Google Scholar, and the Virtual Library of Health databases from December 2020 to August 2022, with a total of five studies included. Inclusion criteria consisted of studies in which the dose adjustment was performed in SCA patients based on pharmacokinetic parameters. Quality analyzes were performed using QAT, while data synthesis was performed according to the Cochrane Manual of Systematic Reviews of Interventions. Analysis of the selected studies revealed improved HU treatment effectiveness using personalized dosages in SCA patients. Moreover, several laboratory parameters were utilized as biomarkers of the HU response, and methods designed to simplify the adoption of this practice were presented. Despite the scarcity of studies on this topic, HU-personalized treatment based on individualized pharmacokinetic profiles represents a viable alternative for SCA patients who are candidates for HU therapy, especially for pediatric patients. Registration number: PROSPERO CRD42022344512.https://www.mdpi.com/1424-8247/16/6/857sickle cell anemiahydroxyureapersonalized dosepharmacokinetics profile |
| spellingShingle | Joelma Santana dos Santos Neres Sètondji Cocou Modeste Alexandre Yahouédéhou Marilda Souza Goncalves Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review Pharmaceuticals sickle cell anemia hydroxyurea personalized dose pharmacokinetics profile |
| title | Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review |
| title_full | Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review |
| title_fullStr | Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review |
| title_full_unstemmed | Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review |
| title_short | Effectiveness of Pharmacokinetic-Guided Hydroxyurea Dose Individualization in Patients with Sickle Cell Anemia: A Mini-Review |
| title_sort | effectiveness of pharmacokinetic guided hydroxyurea dose individualization in patients with sickle cell anemia a mini review |
| topic | sickle cell anemia hydroxyurea personalized dose pharmacokinetics profile |
| url | https://www.mdpi.com/1424-8247/16/6/857 |
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