Prevention

Why?

• Folate supplementation reduces dactylitis in children with homozygous sickle cell (SS) disease and > 2 episodes of dactylitis a year. ^b
• There is no good evidence to support the use of folate in adults.

Folate reduces dactylitis in children

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
children with sickle cell disease and Dactylitis > 2 episodes/ year b	folate	placebo	dactylitis at 12 months	18%	83% (22% to 100%)	7 (4 to 25)