Evidence-based On-call

Sickle cell crisis

Prevention

Consider depo-provera contraception in women ^a

Why?

Women who take depo-provera have fewer painful episodes and fewer episodes of bone pain after 14 months ^a

Depo-provera reduces painful episodes and episodes of bone pain

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
sickle cell disease ^a	depo-provera	placebo	increase in painful crises at 14 months	57%	69% (24% to 100%)	3 (2 to 7)
			bone pain at 14 months	87%	30% (2% to 58%)	4 (2 to 53)