Magnesium for treating sickle cell disease.


BACKGROUND:Sickle cell disease is an autosomal recessive inherited haemoglobinopathy which causes painful vaso-occlusive crises due to sickle red blood cell dehydration. Vaso-occlusive crises are common painful events responsible for a variety of clinical complications; overall mortality is increased and life expectancy decreased compared to the general population. Experimental studies suggest that intravenous magnesium has proven to be well-tolerated in individuals hospitalised for the immediate relief of acute (sudden onset) painful crisis and has the potential to decrease the length of hospital stay. Some in vitro studies and open studies of long-term oral magnesium showed promising effect on pain relief but failed to show its efficacy. The studies show that oral magnesium therapy may prevent sickle red blood cell dehydration and prevent recurrent painful episodes. There is a need to access evidence for the impact of oral and intravenous magnesium effect on frequency of pain, length of hospital stay and quality of life. OBJECTIVES:To evaluate the effects of short-term intravenous magnesium on the length of hospital stay and quality of life in children and adults with sickle cell disease. To determine the effects of long-term oral magnesium therapy on the frequency of painful crises and the quality of life in children and adults with sickle cell disease. SEARCH METHODS:We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register: 01 December 2016.Date of last search of other resources (clinical trials registries): 29 March 2017. SELECTION CRITERIA:We searched for published and unpublished randomized controlled studies of oral or intravenous magnesium compared to placebo or no magnesium. DATA COLLECTION AND ANALYSIS:Authors independently assessed the study quality and extracted the data using standard Cochrane methodologies. MAIN RESULTS:We included five randomized placebo-controlled studies with a total of 386 participants (aged three to 53 years). Two shorter parallel studies (n = 306) compared intravenous magnesium sulphate to placebo (normal saline) for admission to hospital due to a vaso-occlusive crisis, for which we were able to analyse data. The quality of evidence was moderate for studies presenting this comparison mainly due to limitations due to risk of bias and imprecision. Two of the three longer-term studies comparing oral magnesium pidolate to placebo had a cross-over design. The third was a parallel factorial study which compared hydroxyurea and oral magnesium to each other and to placebo over a longer period of time; we only present the comparison of oral magnesium to placebo from this study. The quality of evidence was very low with uncertainty of the estimation.The eight-hourly dose levels in the two studies of intravenous magnesium were different; one used 100 mg/kg while the second used 40 mg/kg. Only one of these studies (n = 104) reported the mean daily pain score while hospitalised (a non-significant difference between groups, moderate quality evidence). The second study (n = 202) reported a number of child- and parent-reported quality of life scores. None of the scores showed any difference between treatment groups (low quality evidence). Data from one study (n = 106) showed no difference in length of stay in hospital between groups (low quality evidence). Both studies reported on adverse events, but not defined by severity as we had planned. One study showed significantly more participants receiving intravenous magnesium experienced warmth at infusion site compared to placebo; there were no differences between groups for other adverse events (low quality evidence).Three studies (n = 80) compared oral magnesium pidolate to placebo. None of them reported data which we were able to analyse. One study (n = 24) reported on the number of painful days and stated there was no difference between two groups (low quality evidence). None of the studies reported on quality of life or length of hospital stay. Two studies (n = 68) reported there were no differences in levels of magnesium in either plasma or red blood cells (moderate quality evidence). Two studies (n = 56) reported adverse events. One reported episodes of mild diarrhoea and headache, all of which resolved without stopping treatment. The second study reported adverse events as gastrointestinal disorders, headache or migraine, upper respiratory infections and rash; which were all evenly distributed across treatment groups (moderate quality evidence). AUTHORS' CONCLUSIONS:Moderate to low quality evidence showed neither intravenous magnesium and oral magnesium therapy has an effect on reducing painful crisis, length of hospital stay and changing quality of life in treating sickle cell disease. Therefore, no definitive conclusions can be made regarding its clinical benefit. Further randomized controlled studies, perhaps multicentre, are necessary to establish whether intravenous and oral magnesium therapies have any effect on improving the health of people with sickle cell disease.


Than NN,Soe HHK,Palaniappan SK,Abas AB,De Franceschi L




Has Abstract


2017-04-14 00:00:00








  • Proton pump inhibitors for chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is a common and progressive disease characterised by chronic cough, airflow limitation and recurrent exacerbations. Since COPD exacerbations are linked to rising mortality and reduced quality of life, the condition poses a substantial burden on individuals, societ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Kikuchi S,Imai H,Tani Y,Tajiri T,Watanabe N

    更新日期:2020-08-25 00:00:00

  • Circulatory volume expansion for aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND:Patients with subarachnoid haemorrhage who develop spasm of the cerebral arteries may suffer from delayed cerebral ischaemia. This may be exacerbated by reduced circulatory volume. Intravenous fluid therapy to expand the circulating volume might reduce the risk of delayed cerebral ischaemia and so reduce the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Feigin VL,Rinkel GJ,Algra A,van Gijn J

    更新日期:2000-01-01 00:00:00

  • Haemostatic drug therapies for acute spontaneous intracerebral haemorrhage.

    abstract:BACKGROUND:Because spontaneous (non-traumatic) intracerebral haemorrhage (ICH) volume influences its outcome and a third of ICHs enlarge by a third within 24 hours of onset, early haemostatic drug therapy might improve outcome. This is an update of a Cochrane review first published in 2006. OBJECTIVES:To examine the c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Al-Shahi Salman R

    更新日期:2009-10-07 00:00:00

  • Traditional corticosteroids for induction of remission in Crohn's disease.

    abstract:BACKGROUND:Historically, corticosteroids have been the most commonly used class of medication for induction of remission in Crohn's disease (CD). Corticosteroids down regulate production of inflammatory cytokines and interfere with NF-kappaB production, thereby blunting inflammatory response. OBJECTIVES:The primary ob...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Benchimol EI,Seow CH,Steinhart AH,Griffiths AM

    更新日期:2008-04-16 00:00:00

  • Fewer-than-four ports versus four ports for laparoscopic cholecystectomy.

    abstract:BACKGROUND:Traditionally, laparoscopic cholecystectomy is performed using two 10-mm ports and two 5-mm ports. Recently, a reduction in the number of ports has been suggested as a modification of the standard technique with a view to decreasing pain and improving cosmesis. The safety and effectiveness of using fewer-tha...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Gurusamy KS,Vaughan J,Rossi M,Davidson BR

    更新日期:2014-02-20 00:00:00

  • Ultra-radical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian cancer.

    abstract:BACKGROUND:Ovarian cancer is the sixth most common cancer among women and the leading cause of death in women with gynaecological malignancies. Opinions differ regarding the role of ultra-radical (extensive) cytoreductive surgery in ovarian cancer treatment.  OBJECTIVES:To evaluate the effectiveness and morbidity asso...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Ang C,Chan KK,Bryant A,Naik R,Dickinson HO

    更新日期:2011-04-13 00:00:00

  • Indacaterol, a once-daily beta2-agonist, versus twice-daily beta₂-agonists or placebo for chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Indacaterol is an inhaled long-acting beta2-agonist that is administered once daily and has been investigated as a treatment for chronic obstructive pulmonary disease (COPD). Four different doses have been investigated (75 mcg, 150 mcg, 300 mcg and 600 mcg). The relative effects of different doses of once-da...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Geake JB,Dabscheck EJ,Wood-Baker R,Cates CJ

    更新日期:2015-01-10 00:00:00

  • Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.

    abstract:BACKGROUND:Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Webster J,Osborne S

    更新日期:2012-09-12 00:00:00

  • Allergen-specific oral immunotherapy for peanut allergy.

    abstract:BACKGROUND:Peanut allergy is one of the most common forms of food allergy encountered in clinical practice.  In most cases, it does not spontaneously resolve; furthermore, it is frequently implicated in acute life-threatening reactions. The current management of peanut allergy centres on meticulous avoidance of peanuts...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Nurmatov U,Venderbosch I,Devereux G,Simons FE,Sheikh A

    更新日期:2012-09-12 00:00:00

  • Penicillin for secondary prevention of rheumatic fever.

    abstract:BACKGROUND:People with a history of rheumatic fever are at high risk of recurrent attacks of rheumatic fever and developing rheumatic heart disease following a streptococcal throat infection. Giving penicillin to these people can prevent recurrent attacks of rheumatic fever and subsequent rheumatic heart disease. Howev...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Manyemba J,Mayosi BM

    更新日期:2002-01-01 00:00:00

  • Effects of glucocorticoids on radiological progression in rheumatoid arthritis.

    abstract:BACKGROUND:Glucocorticoid use in rheumatoid arthritis (RA) is widespread. Two Cochrane Reviews have been published examining the short term clinical benefit of low dose glucocorticoids compared to non-steroidal anti-inflammatory drugs and demonstrate good short term and medium term clinical benefits. The possibility th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Kirwan JR,Bijlsma JW,Boers M,Shea BJ

    更新日期:2007-01-24 00:00:00

  • Vaccines for preventing Japanese encephalitis.

    abstract:BACKGROUND:Vaccination is recognized as the only practical measure for preventing Japanese encephalitis. Production shortage, costs, and issues of licensure impair vaccination programmes in many affected countries. Concerns over vaccine effectiveness and safety also have a negative impact on acceptance and uptake. OBJ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Schiøler KL,Samuel M,Wai KL

    更新日期:2007-07-18 00:00:00

  • Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus.

    abstract:BACKGROUND:Ethnic minority groups in upper-middle-income and high-income countries tend to be socioeconomically disadvantaged and to have a higher prevalence of type 2 diabetes than is seen in the majority population. OBJECTIVES:To assess the effectiveness of culturally appropriate health education for people in ethni...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Attridge M,Creamer J,Ramsden M,Cannings-John R,Hawthorne K

    更新日期:2014-09-04 00:00:00

  • Speech and language therapy for aphasia following stroke.

    abstract:BACKGROUND:Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia. OBJECTIVES:To assess the effects of speech and language therap...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Brady MC,Kelly H,Godwin J,Enderby P,Campbell P

    更新日期:2016-06-01 00:00:00

  • Pyridoxine (vitamin B6) supplementation in pregnancy.

    abstract:BACKGROUND:Vitamin B6 plays vital roles in numerous metabolic processes in the human body, such as nervous system development and functioning. It has been associated with some benefits in non-randomised studies, such as higher Apgar scores, higher birthweights, and reduced incidence of pre-eclampsia and preterm birth. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Thaver D,Saeed MA,Bhutta ZA

    更新日期:2006-04-19 00:00:00

  • Oral misoprostol for induction of labour with a viable fetus.

    abstract:BACKGROUND:Misoprostol is a synthetic prostaglandin which has been used to induce labour. Oral use of the drug misoprostol may be convenient, but an overdose could cause uterine hyperstimulation and precipitate labour which may be life-threatening for both mother and fetus. OBJECTIVES:The objective of this review was ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Alfirevic Z,Howarth G,Gaussmann A

    更新日期:2000-01-01 00:00:00

  • Hydration for treatment of preterm labour.

    abstract:BACKGROUND:Hydration has been proposed as a treatment for women with preterm labour. Theoretically, hydration may reduce uterine contractility by increasing uterine blood flow and by decreasing pituitary secretion of antidiuretic hormone and oxytocin. OBJECTIVES:To evaluate the effectiveness of intravenous or oral hyd...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Stan C,Boulvain M,Hirsbrunner-Amagbaly P,Pfister R

    更新日期:2002-01-01 00:00:00

  • Laparoscopic versus open liver resection for benign and malignant hepatic lesions in adults.

    abstract:BACKGROUND:Liver (hepatic) resection refers to removal of the whole liver, or one or more of its vascular segments. Elective liver resection is mainly performed for benign and malignant liver tumours. The operation can be performed as an open procedure or with a laparoscopic approach. With the advancement of laparoscop...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Rao AM,Ahmed I

    更新日期:2013-05-31 00:00:00

  • Antioxidants for female subfertility.

    abstract:BACKGROUND:A couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success. This may affect up to a quarter of all couples planning a child. It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women. Antioxidants are t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Showell MG,Mackenzie-Proctor R,Jordan V,Hart RJ

    更新日期:2017-07-28 00:00:00

  • Breastfeeding or nipple stimulation for reducing postpartum haemorrhage in the third stage of labour.

    abstract:BACKGROUND:Oxytocin and prostaglandin are hormones responsible for uterine contraction during the third stage of labour. Receptors in the uterine muscles are stimulated by exogenous or endogenous oxytocin leading to uterine contractions. Nipple stimulation or breastfeeding are stimuli that can lead to the secretion of ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Abedi P,Jahanfar S,Namvar F,Lee J

    更新日期:2016-01-27 00:00:00

  • Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents.

    abstract:BACKGROUND:Vomiting caused by acute gastroenteritis is very common in children and adolescents. Treatment of vomiting in children can be problematic and the use of antiemetics remains a controversial issue. There have been concerns expressed about apparently unacceptable levels of side effects such as sedation and extr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Alhashimi D,Al-Hashimi H,Fedorowicz Z

    更新日期:2009-04-15 00:00:00

  • WITHDRAWN: Psychological interventions for those who have sexually offended or are at risk of offending.

    abstract:BACKGROUND:Sexual offending is both a social problem and a public health issue. To date, no positive treatment effects have been found in quasi-experimental institutional treatment programmes. OBJECTIVES:To evaluate effects of psychological interventions on target sexual acts, urges or thoughts for people who have bee...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Kenworthy T,Adams CE,Bilby C,Brooks-Gordon B,Fenton M

    更新日期:2008-10-08 00:00:00

  • Interventions for actinic keratoses.

    abstract:BACKGROUND:Actinic keratoses are a skin disease caused by long-term sun exposure, and their lesions have the potential to develop into squamous cell carcinoma. Treatments for actinic keratoses are sought for cosmetic reasons, for the relief of associated symptoms, or for the prevention of skin cancer development. Detec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gupta AK,Paquet M,Villanueva E,Brintnell W

    更新日期:2012-12-12 00:00:00

  • Mobility management to prevent, reduce, or delay driving a car in teenagers.

    abstract:BACKGROUND:Rates of injury and death caused by car crashes with teenage drivers remain high in most high-income countries. In addition to injury and death, car use includes other non-traffic risks; these may be health-related, such as physical inactivity or respiratory disease caused by air pollution, or have global si...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Ward A,Lewis SR,Weiss H

    更新日期:2020-08-16 00:00:00

  • Botulinum toxin type A therapy for cervical dystonia.

    abstract:BACKGROUND:Cervical dystonia is characterized by involuntary posturing of the head and frequently is associated with neck pain. Disability and social withdrawal are common. In recent years, Botulinum toxin Type A (BtA) has become the first line therapy. However its true efficacy, in particular the potential effect size...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Costa J,Espírito-Santo C,Borges A,Ferreira JJ,Coelho M,Moore P,Sampaio C

    更新日期:2005-01-25 00:00:00

  • Antibiotics for trachoma.

    abstract:BACKGROUND:Trachoma is the world's leading cause of preventable blindness. In 1997 the World Health Organization launched an initiative on trachoma control based on the 'SAFE' strategy (surgery, antibiotics, facial cleanliness and environmental improvement). OBJECTIVES:The aim of this review is to assess the evidence ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Mabey D,Fraser-Hurt N

    更新日期:2002-01-01 00:00:00

  • Interventions for obsessive compulsive symptoms in people with schizophrenia.

    abstract::This is the protocol for a review and there is no abstract. The objectives are as follows: 1 PRIMARY OBJECTIVES:To evaluate clinically meaningful benefits of interventions used to treat clinically significant obsessive compulsive symptoms occurring in people with schizophrenia with regard to global improvement, chang...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Raj M,Farooq S

    更新日期:2005-01-01 00:00:00

  • Operative procedures for fissure in ano.

    abstract:BACKGROUND:Operative techniques commonly used for fissure in ano include: anal stretch, open lateral sphincterotomy, closed lateral sphincterotomy, posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure. Reports of direct comparisons between operative techniques for anal fissure are...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Nelson R

    更新日期:2005-04-18 00:00:00

  • Aminophylline for bradyasystolic cardiac arrest in adults.

    abstract:BACKGROUND:In cardiac ischaemia, the accumulation of adenosine may lead to or exacerbate bradyasystole and diminish the effectiveness of catecholamines administered during resuscitation. Aminophylline is a competitive adenosine antagonist. Case studies suggest that aminophylline may be effective for atropine-resistant ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Hurley KF,Magee K,Green R

    更新日期:2013-08-15 00:00:00

  • Reduction in saturated fat intake for cardiovascular disease.

    abstract:BACKGROUND:Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Hooper L,Martin N,Jimoh OF,Kirk C,Foster E,Abdelhamid AS

    更新日期:2020-05-19 00:00:00