Magnesium for treating sickle cell disease.

Area of Science:

• Hematology
• Pharmacology
• Clinical Trials

Background:

• Sickle cell disease (SCD) is an inherited disorder causing painful vaso-occlusive crises and reduced life expectancy.
• Intravenous magnesium has shown potential for acute crisis relief and reduced hospital stays.
• Oral magnesium's long-term effects on pain and dehydration are promising but require further evidence.

Purpose of the Study:

• To evaluate short-term intravenous magnesium's impact on hospital stay and quality of life in SCD patients.
• To determine long-term oral magnesium therapy's effect on painful crisis frequency and quality of life in SCD patients.

Main Methods:

• Searched Cochrane Haemoglobinopathies Trials Register and clinical trial registries up to April 2019.
• Included five randomized placebo-controlled studies (n=386) comparing oral or intravenous magnesium to placebo.
• Assessed study quality and extracted data using standard Cochrane methodologies.

Main Results:

• Moderate quality evidence indicated no significant difference in pain scores or length of hospital stay with intravenous magnesium.
• Low quality evidence showed no improvement in quality of life or pain frequency with intravenous or oral magnesium.
• Adverse events were generally mild and similar between magnesium and placebo groups.

Conclusions:

• Moderate to low quality evidence suggests neither intravenous nor oral magnesium therapy effectively reduces painful crises, hospital stay, or improves quality of life in SCD.
• Definitive conclusions on clinical benefit cannot be made.
• Further multicenter randomized controlled trials are necessary to establish the efficacy of magnesium therapies in SCD.