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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?
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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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