{"id":16942,"date":"2023-07-03T14:57:18","date_gmt":"2023-07-03T12:57:18","guid":{"rendered":"https:\/\/www.hematostat.net\/?p=16942"},"modified":"2024-12-11T18:58:49","modified_gmt":"2024-12-11T17:58:49","slug":"un-effet-protecteur-inattendu-de-lhydroxyuree-hu-sur-le-paludisme","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/un-effet-protecteur-inattendu-de-lhydroxyuree-hu-sur-le-paludisme\/","title":{"rendered":"Un effet protecteur inattendu de l\u2019Hydroxyur\u00e9e (HU) sur le paludisme"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 4 (2) : R75<\/p>\n

<\/em>Olupot-Olupot P, Tomlinson G, Williams TN, Tshilolo L, Santos B, Smart LR et al. Hydroxyurea treatment is associated with lower malaria incidence in children with sickle cell anemia in sub-Saharan Africa. <\/em>Blood<\/em>. 2023 23;141(12):1402-1410.<\/em><\/a><\/em><\/p>\n

R\u00e9sum\u00e9 de l\u2019article<\/strong><\/p>\n

L\u2019essai prospectif REACH a montr\u00e9 une r\u00e9duction de l\u2019incidence du paludisme chez des enfants dr\u00e9panocytaires trait\u00e9 par HU (IRR 0,49 95 %[CI]<\/sub>[0.37-0.66]; p<0,001). Il s\u2019agit ici d\u2019une analyse longitudinale des cas av\u00e9r\u00e9s de paludisme (n=346) des enfants inclus dans REACH (n=606), rapportant que la neutrop\u00e9nie mod\u00e9r\u00e9e < 3G\/L (p=0,005) et que l\u2019absence de spl\u00e9nom\u00e9galie (p<0,001) \u00e9taient 2 facteurs associ\u00e9s \u00e0 une r\u00e9duction du risque de paludisme.<\/p>\n

Dans nos pratiques<\/strong><\/p>\n

L\u2019HU est la principale arme th\u00e9rapeutique chez les patients dr\u00e9panocytaires en Afrique subsaharienne, o\u00f9 le paludisme reste un probl\u00e8me de sant\u00e9 publique. Les m\u00e9canismes du r\u00f4le protecteur de l\u2019HU restent incompris, cette \u00e9tude sugg\u00e9rant un r\u00f4le potentiel des neutrophiles (inflammation exacerb\u00e9e, adh\u00e9sion vasculaire ?), une toxicit\u00e9 directe de l\u2019HU contre le plasmodium ou encore la spl\u00e9nom\u00e9galie comme \u00e9tant un r\u00e9servoir potentiel parasitaire.<\/p>\n

Le regard du biostatisticien<\/strong><\/p>\n

Cette \u00e9tude similaire \u00e0 un essai clinique de phase II sur une population p\u00e9diatrique tr\u00e8s sp\u00e9cifique a montr\u00e9 une r\u00e9duction de moiti\u00e9 du risque relatif de cas de paludisme gr\u00e2ce \u00e0 la prise de HU. De nombreux \u00e9l\u00e9ments laissent \u00e0 penser que ces r\u00e9sultats sont solides et que les analyses furent r\u00e9ellement rigoureuses, comme l\u2019utilisation de variables temps-d\u00e9pendantes dans les mod\u00e8les de Cox, la prise en compte du risque d\u2019infection suivant la saison, le pays, ou encore de transformations de variables continues. \u00c0 quand une confirmation par un essai de phase III ?<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":16945,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[],"ppma_author":[459],"class_list":["post-16942","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","author-lin-pierre-zhao"],"aioseo_notices":[],"authors":[{"term_id":459,"user_id":0,"is_guest":1,"slug":"lin-pierre-zhao","display_name":"Lin-Pierre ZHAO","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2023-03-29-a-12.52.50-1.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2023-03-29-a-12.52.50-1.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.
\r\nChef de clinique assistant
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\r\nCorrespondance : <\/strong>Service H\u00e9matologie S\u00e9niors - Tr\u00e8fle 4 | H\u00f4pital Saint-Louis | Universit\u00e9 Paris Cit\u00e9\r\nInserm U1160 | Institut de Recherche Saint-Louis\r\n1 avenue Claude Vellefaux, 75010 Paris.
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