Introdução: A doença falciforme (DF) é um espectro de condições hematológicas caracterizado por alterações a nível molecular e estrutural da hemoglobina, implicando sua polimerização e alteração morfológica da hemácia quando há hipóxia. Isso causa obstruções no fluxo sanguíneo, implicando dor intensa e danos perfusionais. Está, portanto, associada à alta taxa de morbi-mortalidade. A hidroxiureia (HU) é o único tratamento licenciado para DF. Devido à capacidade de aumentar níveis de hemoglobina fetal (HbF), tem sido associada a melhora significativa de sintomas, principalmente dor. Objetivos: Pesquisar, através de uma revisão sistemática, a eficácia e os efeitos adversos da HU em falcêmicos. Material e Métodos: Revisão de literatura nas bases de dados MedLine e SciELO, em janeiro/2021. Os descritores usados foram “Hydrea”, “HbS Disease”, “Hematology” e variações encontradas no MeSH; já os filtros, “free full text”, “meta-analysis”, “english” e “10 years”. Foram encontrados 9 estudos e 6 fizeram parte do escopo deste trabalho. A escala PRISMA foi utilizada objetivando melhorar a revisão. Resultados: A HU mostrou-se eficaz na redução da frequência de episódios álgicos e outras complicações agudas, taxas de STA e transfusão, internações hospitalares, marcadores hemolíticos, aumento da hemoglobina basal. Indivíduos tratados com HU obtiveram taxa de sobrevida maior, comparando-se aos que não usaram; além de prevenir eventos neurológicos graves e ser bem tolerada. O uso da HU requer monitoramento, pois são reconhecidos efeitos adversos como erupções cutâneas, cefaleia, efeitos gastrointestinais e teratogênicos, neutropenia, plaquetopenia, anemia, mielotoxicidade e mielodisplasia. A HU não evitou sequestro esplênico/hepático. As evidências são inconsistentes quanto aos benefícios e riscos a longo prazo, dose recomendada, prejuízos na fertilidade masculina e uso em indivíduos HbSC. Conclusão: Sobretudo devido à ação nos níveis de HbF, é notória a eficácia e segurança da HU na expectativa e qualidade de vida na DF. A HU é considerada um agente modificador de doença.
Publicado
2021-02-01
Como Citar
Ferraz, N. de O., Martins, . L. D., Barbosa, L. de O., Paiva, P. C. D., & Heleno, C. T. (2021). AVALIAÇÃO DA EFICÁCIA E DOS EFEITOS ADVERSOS DA HIDROXIUREIA NO TRATAMENTO DA DOENÇA FALCIFORME: UMA REVISÃO SISTEMÁTICA. Revista Multidisciplinar Em Saúde, 2(1), 22. https://doi.org/10.51161/rems/630
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