Does the dose of hydroxyurea correlate with shorter hospital stay and higher fetal hemoglobin levels in patients with sickle cell disease? - Research Article

Q: How does HU dose relate to hospital length of stay in adults with SCD?

In the study, adults on high-dose HU had a significantly shorter median length of stay (2 days) than adults on low-dose HU (7 days; p < 0.001).

Q: What secondary outcomes were assessed besides length of stay?

The study assessed VOC frequency and hemoglobin electrophoresis findings, including fetal hemoglobin (HbF) and hemoglobin S (HbS) percentages.

Q: Did higher-dose hydroxyurea change annual VOC rates?

No. Annual VOC rates showed no significant difference between the low- and high-dose groups (p = 0.132).

Q: What overall conclusion did the authors draw about high-dose HU?

High-dose HU was associated with shorter hospital stays and favorable hematologic outcomes, including improved HbF and HbS parameters in adults with SCD.

Sep 30, 2026

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Sickle cell disease (SCD) causes recurrent vaso-occlusive crises (VOC) and frequent hospitalizations, creating a substantial healthcare burden. Hydroxyurea (HU) is known to reduce VOC frequency and hospitalization rates, yet evidence comparing different HU doses on length of stay and adult clinical outcomes remains limited. This retrospective study evaluated high- versus low-dose HU in adults admitted to medical wards, using secondary endpoints including VOC frequency and hemoglobin electrophoresis results, with statistical significance at p < 0.05.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Background & Aims

Methods

Results

Conclusion

Plain Language Summary

Study comparison and outcomes

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Introduction

Future Science OA 2026, VOL. 12, nO. 1, 2610223 [https://doi.org/10.1080/20565623.2025.2610223](https://doi.org/10.1080/20565623.2025.2610223) ReseaRch aRticle “Does the dose of hydroxyurea correlate with shorter hospital stay and higher fetal hemoglobin levels in patients with sickle cell disease?” Musa Fares alzahrania,b, abdulaziz albackera\#, abdulmajeed alshabanata, Maram alharbib, Jawahirabuhaimedc, Nouran arnousa, Yara alzahrania, hind aloraierb,d, Maha alamria, Rawan altamimie, Ghazi alotaibia,b, sarah sewaralthahaba,b, Fatima alshaltib, ibrahim alrumaihb, ahmad Jamalb, Farjah algahtania,b and aamer aleema,b aDepartment of Medicine, college of Medicine, King Saud university, riyadh, Saudi Arabia; bOncology center, Department of Hematology, King Saud university Medical city, riyadh, Saudi Arabia; ccollege of Medicine, transfusion Medicine Department, Alfaisal university, riyadh, Saudi Arabia; dinternal Medicine Department, riyadh First Health cluster, riyadh, Saudi Arabia; eMinistry Of Health, Seha Virtual Hospital, Department of Medicine, riyadh, Saudi Arabia ABSTRACT Background & Aims: sickle cell disease (scD) leads to recurrent vaso-occlusive crises (VOc) and hospitalizations, imposing a substantial healthcare burden. hydroxyurea (hU) is known to reduce VOc frequency and hospitalization rates in scD; however, data comparing the impact of different hU doses on length of stay (lOs) and clinical outcomes in adults are limited. Methods: this retrospective study assessed the effect of high- versus low-dose hU on lOs among adults with scD admitted to medical wards. secondary endpoints included VOc frequency and hemoglobin electrophoresis findings. Pearson’s chi-square and Mann–Whitney tests were used, with significance set at p < 0.05. Results: a total of 141 patients were analyzed (26 on low-dose, 115 on high-dose hU), with a median age of 31 years; 52.5% were female. the overall median lOs was 3 days (iQR 1–10). the low-dose group had a significantly longer median lOs (7 days [iQR 7–9]) compared with the high-dose group (2 days [iQR 2–3]; p < 0.001). higher hU doses were also associated with improved hgb F% and hgb s%(p < 0.001), while annual VOc rates showed no significant difference (p = 0.132). Conclusion: high-dose hU was linked to shorter hospital stays and favorable hematologic outcomes in adults with scD. PLAIN LANGUAGE SUMMARY this study focuses on how hydroxyurea (hU), a common medication for sickle cell Disease (scD), affects hospital stays and blood health in adults. Patients with sickle cell Disease often experience “pain crises” (vaso-occlusive crises) that require hospital treatment. While we know hU helps prevent these crises, there isn’t enough information on whether the size of the dose makes a difference in how long a patient stays in the hospital. the researchers looked at 141 adults with scD. they compared two groups: • low-dose group: 26 patients. • high-dose group: 115 patients. they measured the length of stay (lOs)—the number of days a patient spent in the hospital—and checked their blood levels to see how well the medication was working. the study found that patients on a higher dose of hU had much better outcomes: • shorter hospital stays: Patients on high doses stayed in the hospital for a median of 2 days, while those on low doses stayed for 7 days. • Better Blood levels: high doses led to better levels of “fetal hemoglobin” (hgb F), which helps protect against cell damage. • Pain crises: Both groups had similar yearly rates of pain crises, but the severity or recovery time appeared to favor the high-dose group. ARTICLE HISTORY Received 21 October 2025 accepted 23 December 2025 KEYWORDS sickle cell disease; sickle; scD; hydroxyurea; vaso-occlusive crisis CONTACT Musa Alzahrani [malzahrani@ksu.edu.sa](malzahrani@ksu.edu.sa) Department of Medicine, King Saud university, Saudi Arabia, P O Box: 55068 (37), King Khalid road, riyadh, riyadh Prov

FAQs

How does HU dose relate to hospital length of stay in adults with SCD?

In the study, adults on high-dose HU had a significantly shorter median length of stay (2 days) than adults on low-dose HU (7 days; p < 0.001).

What secondary outcomes were assessed besides length of stay?

The study assessed VOC frequency and hemoglobin electrophoresis findings, including fetal hemoglobin (HbF) and hemoglobin S (HbS) percentages.

Did higher-dose hydroxyurea change annual VOC rates?

No. Annual VOC rates showed no significant difference between the low- and high-dose groups (p = 0.132).

What overall conclusion did the authors draw about high-dose HU?

High-dose HU was associated with shorter hospital stays and favorable hematologic outcomes, including improved HbF and HbS parameters in adults with SCD.

Sep 30, 2026

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