Hydroxyurea therapy in adult Nigerian sickle cell disease: a monocentric survey on  pattern of use, clinical effects and patient’s compliance.

Ademola Samson Adewoyin1, Omokiniovo Sunday Oghuvwu, Omolade Augustina Awodu

1. Department of Haematology and Blood Transfusion, University of Benin Teaching Hospital, PMB 1111,
Benin City, Nigeria
2. Department of Internal Medicine, Clinical Pharmacology and Therapeutics Unit, University of Benin
Teaching Hospital, PMB 1111, Benin City, Nigeria

Abstract
Background: The clinical prospects of hydroxyurea therapy in the management of sickle cell disease (SCD) require evaluation in the Nigerian setting to develop indigenous guidelines. This survey examines the pattern of hydroxyurea therapy, its clinico-haematologic benefits and safety profile in Nigerian SCD subjects.

Methods: A cross sectional pilot survey was carried out among 60 adult SCD subjects over 3 months. Data on clinical phenotypes, relevant haematological parameters and details of hydroxyurea therapy were obtained using a structured questionnaire through an interview process and case file review.

Results:The median age was 30 years. Thirty-four (56.7%) of the subjects are aware of hydroxyurea therapy in SCD. Twenty-four (40%) SCD patients had previously used hydroxyurea. Only 4 subjects were fully compliant. Reasons for non-compliance included poor knowledge and lack of funds. In particular, hydroxyurea reduced leucocyte count and increased mean red cell volume (MCV) in compliant subjects.

Conclusion: Hydroxyurea use is low among Nigerian SCD subjects despite its proven efficacy/clinical prospects in the developed nations. Large scale multicenter studies and clinical trials are needed to form a basis for developing standard local treatment protocol for its use.

Keywords: Hydroxyurea therapy, Nigerian sickle cell disease, pattern of use, clinical effects, patient’s compliance