{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T03:25:24Z","timestamp":1769138724314,"version":"3.49.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Backgrounds<\/jats:title>\n                    <jats:p>Hydroxyurea (HU) remains underutilized in adults with sickle cell disease (SCD) despite proven benefits. Current HU guidelines primarily target sickle cell anemia (SCA), overlooking other genotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examined HU utilization patterns across genotypes among adults considered to have moderate to severe SCD manifestations by the 2014 National Heart, Lung, and Blood Institute (NHLBI) guideline criteria and identified factors associated with early HU use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study analyzed electronic health records from the University of Pittsburgh Medical Center (2014\u20132024) of adults with SCD experiencing three or more vaso\u2010occlusive crises (VOCs) within 12\u2009months. HU utilization rates, stratified by genotype, were assessed at 30\u2010, 90\u2010, 180\u2010, and 365\u2010day intervals after the third VOC episode (\n                      <jats:italic>index date<\/jats:italic>\n                      ). Multivariable logistic regression was used to identify factors associated with HU use within 90\u2009days post\u2010index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 411 adults with moderate to severe SCD (\u2265\u20093 VOCs within a year), with a mean age of 42.4\u2009\u00b1\u200917.9\u2009years and 61.3% female, only 19.5% received HU within 90\u2009days post\u2010index. Although 42.8% of SCA patients received HU within 1\u2009year, only 8.0% of non\u2010SCA patients received the treatment. The SCA genotype was the strongest predictor of HU use (odds ratio [OR]\u2009=\u20094.5, 95% confidence interval [CI]: 2.4\u20138.7), followed by pulmonary complications. Additional barriers included older age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite guideline recommendations since 2014, HU remains underutilized. Non\u2010SCA patients meeting the severity threshold for HU use are consistently undertreated, highlighting an urgent need for studies establishing HU safety and efficacy in non\u2010SCA genotypes. Future studies should also address age barriers to optimize HU use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70099","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T08:22:27Z","timestamp":1768378947000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genotype Differences and Hydroxyurea Utilization Among Adults With Moderate to Severe Sickle Cell Disease"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8871-3319","authenticated-orcid":false,"given":"Siang\u2010Hao","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Pharmacy &amp; Therapeutics University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3010-8285","authenticated-orcid":false,"given":"Enrico M.","family":"Novelli","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-742X","authenticated-orcid":false,"given":"Hyeun Ah","family":"Kang","sequence":"additional","affiliation":[{"name":"The University of Texas at Austin College of Pharmacy Health Outcomes Division  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri V.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy &amp; Therapeutics University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7906-9398","authenticated-orcid":false,"given":"Kangho","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy &amp; Therapeutics University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21880"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2013.09.001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.70310"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745\u20107599.2009.00416.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.378"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.36469\/jheor.2020.12852"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904013401307"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10517"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102014\u201008\u2010435768"},{"key":"e_1_2_10_11_1","volume-title":"Evidence\u2010Based Management of Sickle Cell Disease: Expert Panel Report, 2014","author":"National Heart Lung, and Blood Institute","year":"2014"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.3075"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102019\u2010125799"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.44546"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S97405"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102024\u2010204408"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(23)00118\u20107"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.022"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19523"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.055202"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10140"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023009993"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102016\u2010000206"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28703"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018017541"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26765"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.15326\/jcopdf.2.3.2014.0151"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010015\u20101217\u20106"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18981"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001743"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102023\u2010188979"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022009049"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.28971"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60010124"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102024\u2010211859"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12878"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010017\u20100713\u2010x"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/hemato2040048"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1367279"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19099"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2022.921432"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation\u20102014.1.432"},{"key":"e_1_2_10_43_1","volume-title":"StatPearls [Internet]","author":"Friend A. 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