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Crizanlizumab (Adakveo°) to prevent vaso-occlusive crises in sickle-cell disease: No proven clinical advantages

FEATURED REVIEW Is crizanlizumab more effective than hydroxycarbamide for patients with sickle-cell disease? Does it prevent vaso-occlusive crises and their serious complications when hydroxycarbamide is not sufficiently effective or cannot be used? What is its adverse effect profile?
Full review (5 pages) available for download by subscribers.

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  •  NOTHING NEW  The only available comparative trial of crizanlizumab (versus placebo) in patients with sickle-cell disease and vaso-occlusive crises failed to provide robust evidence that crizanlizumab tangibly reduces the frequency of vaso-occlusive crises. Nor did it show a reduction in the most serious complications of vaso-occlusive crises. Crizanlizumab appears to mainly carry a risk of gastrointestinal and musculoskeletal disorders, and infusion-related reactions. The risk of haemostatic disorders will need to be monitored. In practice, as of late 2021, the treatments of choice for preventing vaso-occlusive crises due to sickle-cell disease remain hydroxycarbamide, or repeated blood transfusions or exchange transfusions when hydroxycarbamide cannot be used or is insufficiently effective. 

 
©Prescrire 1 January 2022

Source: "Crizanlizumab (Adakveo°) to prevent vaso-occlusive crises in sickle-cell disease. No proven clinical advantages, either as an adjunct to or instead of hydroxycarbamide" Prescrire International 2022; 31 (233): 5-8. Subscribers only.

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