Sickle cell anaemia: piracetam reduced crises, hospitalisations and transfusions in children.

Clinical bottom line (level 1b)

  1. Children with severe sickle cell disease who were given piracetam regularly had fewer crises, hospitalisations and blood transfusions in the next year, than those who were given placebo.
El-Hazmi et al: Acta Haematologica 1996; 96: 221-226
Expires December 2003

The study

Double-blinded concealed randomised trial with intention-to-treat
Setting: thirteen acute hospitals, Saudi Arabia

87 patients (aged <12 years, 57% male) children with severe sickle cell disease (using a severity score based on clinical events and biochemical markers) in crisis
Control Group: (n = 39, 39 analysed): placebo
Experimental Group: (n = 48, 48 analysed): piracetam i.v. 300 mg/kg/day and continued on 160 mg/kg/day po on discharge

100% followed for 12 months

The evidence

Outcome Control Group
(SD)		 Experimental Group
(SD)		 Mean Difference
(95% CI)
decrease in number of crises -0.20
(1.2) 		3.4
(1.2) 		3.6
(3.1 to 4.1)
decrease in hospitalisations 0.20
(1.2) 		2.4
(1.1) 		2.2
(1.7 to 2.7)
decrease in blood transfusions 0.60
(0.92) 		2.2
(1.2) 		1.6
(1.1 to 2.1)

  • No effect was noted on haematological markers.
  • No comment was made about side effects.
  • Study is important to replicate in view of the scarcity of the literature

    • Comments

    1. A study on adults would be interesting.

    Citation

    1. El-Hazmi MAF, Warsy AS, Al-Fawaz J, et al: Piracetam is useful in the treatment of children with sickle cell disease. Acta Haematologica 1996; 96: 221-226
    Search Terms: sickle in Cochrane
    Contributor: Chris Ball and Clare Wotton, May 2000
    Reviewer: Mona Nabulsi

    Clinical Question.
    Patient sickle cell disease
    Intervention or Exposure piracetam
    Comparison placebo
    Outcome decrease in crises