Summary

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• This summary is based on the review of seven systematic review(s)/meta-analysis(es). ^[1-7]
• Crizanlizumab reduced the frequency of vaso-occlusive crises (VOC) by 45% and prolonged the time to the first and second VOC in the SUSTAIN trial. It showed a hazard ratio (HR) of 0.55 (95% credible interval 0.43 to 0.69) for VOC reduction, with a Bayesian probability of superiority >0.99.
• Compared to L-glutamine, crizanlizumab demonstrated a greater reduction in VOC frequency (HR 0.67, 95% confidence interval 0.50 to 0.88), while voxelotor was not effective in reducing VOCs but significantly increased hemoglobin levels (p < 0.001).
• The effectiveness of crizanlizumab in reducing VOCs was consistent across various subgroups, including patients on hydroxyurea and those with prior VOC history.
• Crizanlizumab demonstrated a safety profile comparable to placebo, with no significant differences in adverse events (HR 0.91, 95% CI (confidence interval) 0.59 to 1.43) or serious adverse events (HR 0.93, 95% CI 0.47 to 1.87) in the SUSTAIN trial and the network meta-analysis.
• The most common adverse event across crizanlizumab, L-glutamine, and voxelotor was pain, with no specific significant safety concerns reported in any population or subgroup.
• Crizanlizumab was effective in reducing VOCs and all-cause hospitalization days in older adolescents and adults (≥16 years old) and showed consistent effectiveness in reducing VOCs regardless of concomitant hydroxyurea use or prior VOC history.