Lower hemoglobin levels are linked to higher rates of organ damage¹

History of organ damage by hemoglobin levels
in patients with sickle cell disease¹

Bar chart showing an association between history of organ damage in patients with sickle cell disease and hemoglobin levels

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Study design

This retrospective, observational study from a US healthcare database examined the relationship between hemoglobin levels and end-organ damage in SCD. The study included 16,043 patients aged ≥12 years with SCD and at least 1 Hb measurement. The mean age group was 35-49. Data spanned from January 1, 2012, through July 31, 2020.¹

Each Hb value was treated as a separate observation. Onset of end-organ damage was determined by the index date to the end of the following 1-year period, last activity date, or day before the next Hb value, whichever was earliest.¹

Organ damage refers to incidence of chronic kidney disease, pulmonary hypertension, stroke, and leg ulcers.¹

Hb=hemoglobin; SCD=sickle cell disease.

Even relatively modest decreases in Hb correspond with increased organ damage and mortality risk²

Mean Hb difference in patients
with complications vs those without²

Bar chart showing the mean difference in hemoglobin levels for patients with various complications vs those without

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Design

ePASP=estimated pulmonary artery systolic pressure; Hb=hemoglobin; SCI=silent cerebral infarction; TCD=transcranial doppler ultrasound.

Increasing Hb by ≥1 g/dL is associated with lower risk of organ damage and mortality^1,2

Meta-analyses modeled risk reduction in clinical
outcomes associated with ≥1 g/dL Hb increase²

Bar chart showing the modeled decrease in risk for clinical outcomes associated with >1 g/dL increase in hemoglobin

Figure adapted from Ataga et al.

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Study design

ePASP=estimated pulmonary artery systolic pressure; Hb=hemoglobin; SCI=silent cerebral infarction.

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References:

1. Ershler WB, De Castro LM, Pakbaz Z, et al. Hemoglobin and end-organ damage in individuals with sickle cell disease. Curr Ther Res Clin Exp. 2023;98:100696. doi:10.1016/j.curtheres.2023.100696 2. Ataga KI, Gordeuk VR, Agodoa I, Colby JA, Gittings K, Allen IE. Low hemoglobin increases risk for cerebrovascular disease, kidney disease, pulmonary vasculopathy, and mortality in sickle cell disease: a systematic literature review and meta-analysis. PLoS One. 2020;15(4):e0229959. doi:10.1371/journal.pone.0229959

Damage in Sickle Cell Disease

Lower hemoglobin levels are linked to higher rates of organ damage1

History of organ damage by hemoglobin levels in patients with sickle cell disease1

Study design

Even relatively modest decreases in Hb correspond with increased organ damage and mortality risk2

Mean Hb difference in patientswith complications vs those without2

Design

Increasing Hb by ≥1 g/dL is associated with lower risk of organ damage and mortality1,2

Meta-analyses modeled risk reduction in clinicaloutcomes associated with ≥1 g/dL Hb increase2

Study design

See the link between hemolysis markers and organ damage

See the current treatment landscape for sickle cell disease

Lower hemoglobin levels are linked to higher rates of organ damage¹

History of organ damage by hemoglobin levels
in patients with sickle cell disease¹

Even relatively modest decreases in Hb correspond with increased organ damage and mortality risk²

Mean Hb difference in patients
with complications vs those without²

Increasing Hb by ≥1 g/dL is associated with lower risk of organ damage and mortality^1,2

Meta-analyses modeled risk reduction in clinical
outcomes associated with ≥1 g/dL Hb increase²

See the current treatment landscape for
sickle cell disease