According to a research that was published online on March 24 in JAMA Network Open, despite the fact that national guidelines encourage the use of hydroxyurea for the treatment of sickle cell anemia (SCA), very few young people with SCA actually receive it.
Before and after the release of the 2014 guidelines from the United States National Heart, Lung, and Blood Institute, researchers led by Sarah L. Reeves, Ph.D., from the University of Michigan in Ann Arbor, and their colleagues investigated changes in the use of hydroxyurea among young people diagnosed with SCA.
The study looked at administrative records for 4,302 children and adolescents between the ages of 1 and 17 who were diagnosed with SCA and participated in the Medicaid programs of Michigan and New York State (2010 to 2018).
According to the findings of the study, the researchers observed that the mean annual days’ supply of hydroxyurea per patient in Michigan was 47.2 days, but in New York it was 97.4 days. Once the rules were published, there was a 1.52-fold increase in the probability that Michigan would have a supply of more than zero days after they were implemented, however in New York there was no change in the average number of days that filled hydroxyurea would be available.
“These findings suggest that hydroxyurea was substantially underused among youths with SCA,” the authors write. “This is despite the fact that hydroxyurea has been established as the primary disease-modifying therapy for SCA.” In addition, “there was incomplete clinician or patient uptake of newly released guidelines.” “The findings indicate that extending the use of hydroxyurea may need a multidimensional approach that addresses several hurdles at both the patient and the system level,”