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May 28, 2008
Marquette General Physician, Dr. Aaron Scholnik, co-authors statement on hydroxyurea treatment in sickle cell anemia patients
Statements says hydroxyurea treatment is underutilized for sickle cell disease
Marquette General Physician, Dr. Aaron Scholnik of U.P. Hematology/Oncology Associates, and Medical Director of the Cancer Research Office at the Marquette General Cancer Center, has co-authored “National Institutes of Health Consensus Development Conference Statement: Hydroxyurea Treatment for Sickle Cell Disease.” The statement has been published in the latest edition of “Annals of Internal Medicine.”
Dr. Aaron Scholnik
The statement was written by 14 experts in the field, including Dr. Scholnik, who were nominated by The National Institutes of Health to participate as panel members at the NIH Consensus Development Conference, held February 2008. The purpose of the conference was to assess the body of evidence relating to the use of hydroxyurea in sickle cell anemia patients of all ages, and the barriers to care in the sickle cell anemia population.
Sickle cell anemia is a chronic, anemia of which there is no cure. It’s marked by sickle-shaped red blood cells, occurring mostly in black people of Africa or of African descent. Hydroxyurea is a drug that treats sickle cell anemia by changing red blood cells so they are less likely to bend into an abnormal shape. In the United States, this inherited blood disorder affects 50,000 to 100,000 people.
The conference examined the effectiveness of hydroxyurea treatment for patients who have sickle cell anemia, and the short and long-term disadvantages of those treatments.
The panel concluded that the use of hydroxyurea for sickle cell patients should be increased in adolescents and adults. Hydroxyurea was approved by the U.S. Food and Drug Administration for use in adults with sickle cell anemia in 1998, but provider and patient concerns have hindered its use, depriving many patients of its proven benefits.
Research has shown that sickle cell patients on this drug experience fewer pain crises and hospital admissions, and the panel advocated increased utilization of this drug with appropriate monitoring. Additionally, the panel concluded that the risks of serious side effects of hydroxyurea appear to be lower than previously expected. Furthermore, these risks are acceptable when compared to the risks of untreated sickle cell disease in adolescents and adults.
For younger patients, safety and efficacy data are limited but supportive of hydroxyurea treatment. Although the panel was unable to definitively recommend broad pediatric use of the drug at this time, it is hoped that results from ongoing clinical trials will help to resolve remaining questions.
The panel's statement is an independent report and is not a policy statement of the NIH or the federal government. The NIH Consensus Development Program was established in 1977 as a mechanism to judge controversial topics in medicine and public health in an unbiased, impartial manner. NIH has conducted 118 consensus development conferences, and 29 state-of-the-science (formerly "technology assessment") conferences, addressing a wide range of issues.
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