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Evaluation of hydroxyurea effect in patients with sickle cell disease: A prospective observational study

Anusha Battina, Snehalata Gajbhiye, Chaitali Chindhalore, Ganesh N. Dakhale and 5 more

Indian Journal of Pharmacology | Sep 1, 2026

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HU may exert therapeutic benefit not only by increasing HbF but also through anti-inflammatory and antioxidant effects, leading to improved hematological stability and fewer complications in SCD.

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BACKGROUND AND OBJECTIVES: Sickle cell disease (SCD) is characterized by chronic hemolysis, inflammation, oxidative stress, and recurrent vaso-occlusive complications leading to significant morbidity. Hydroxyurea (HU), a widely used disease-modifying therapy, increases fetal hemoglobin (HbF) and reduces clinical complications. Emerging evidence suggests additional anti-inflammatory and antioxidant effects. The objectives of this study were to compare the inflammatory markers, oxidative stress markers, hematological parameters, and quality of life from baseline to 6 months after HU therapy among patients with SCD. MATERIALS AND METHODS: In this prospective observational study, 16 HU-naïve patients with SCD were evaluated at baseline and after 6 months of HU therapy. Investigations included inflammatory markers (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]), oxidative stress markers (malondialdehyde [MDA] and glutathione [GSH]), hematological parameters (HbF, sickle hemoglobin [HbS], leukocyte count, and neutrophil-to-lymphocyte ratio [NLR]), and quality of life assessed using the 36-Item Short Form Health Survey questionnaire. RESULTS: Significant reductions in inflammatory markers were observed, with TNF-α decreasing from 5.82 ± 2.82 pg/mL to 4.64 ± 2.65 pg/mL (P = 0.006) and median IL-6 levels decreasing from 6.32 to 4.42 pg/mL (P = 0.001). Oxidative stress improved, with reduced MDA levels (P = 0.011) and increased GSH levels (P = 0.001). Hematological parameters showed significant improvement, including increased HbF and reductions in HbS, leukocyte count, and NLR (P < 0.001). HU therapy was well tolerated, with good compliance, improved quality of life, and a low incidence of complications. CONCLUSION: HU may exert therapeutic benefit not only by increasing HbF but also through anti-inflammatory and antioxidant effects, leading to improved hematological stability and fewer complications in SCD.

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Anusha Battina

first | All India Institute of Medical Sciences Raipur

Snehalata Gajbhiye

middle | All India Institute of Medical Sciences Raipur

Chaitali Chindhalore

middle | All India Institute of Medical Sciences Raipur

Ganesh N. Dakhale

middle | All India Institute of Medical Sciences Raipur | ORCID 0000-0002-4022-3001

Apurva Bhoyar

middle | All India Institute of Medical Sciences Raipur

Amol Dube

middle | All India Institute of Medical Sciences Jodhpur

Sunita Kumbhalkar

middle | All India Institute of Medical Sciences Jodhpur

Vishvdeep Khushoo

middle | All India Institute of Medical Sciences Jodhpur

Richa Juneja

last | All India Institute of Medical Sciences Raipur

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BibTeX

@article{Battina2026Evaluation,
  title = {Evaluation of hydroxyurea effect in patients with sickle cell disease: A prospective observational study},
  author = {Anusha Battina and Snehalata Gajbhiye and Chaitali Chindhalore and Ganesh N. Dakhale and Apurva Bhoyar and Amol Dube and Sunita Kumbhalkar and Vishvdeep Khushoo and Richa Juneja},
  journal = {Indian Journal of Pharmacology},
  year = {2026},
  doi = {10.4103/ijp.ijp_270_26},
  url = {https://doi.org/10.4103/ijp.ijp_270_26}
}

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