Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Feb 12;2(2):CD006111.
doi: 10.1002/14651858.CD006111.pub3.

Piracetam for reducing the incidence of painful sickle cell disease crises

Amani Al Hajeri  1 , Zbys Fedorowicz
Affiliations
Meta-Analysis

Piracetam for reducing the incidence of painful sickle cell disease crises

Amani Al Hajeri et al. Cochrane Database Syst Rev. .

Abstract

Background: Sickle cell disease is one of the most common genetic disorders. Sickle cell crises in which irregular and dehydrated cells contribute to blocking of blood vessels are characterised by episodes of pain. Treatment is mainly supportive and symptomatic. In vitro studies with piracetam indicate that it has the potential for inhibition and a reversal of the process of sickling of erythrocytes. This is an update of a previously published Cochrane review.

Objectives: To assess the effectiveness of piracetam for reducing the incidence of painful sickle cell disease crises.

Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Last search of the Group's Haemoglobinopathies Trials Register: 21 September 2015.

Selection criteria: Randomised controlled trials comparing orally administered piracetam to placebo or standard care in people, of all ages and both sexes, with sickle cell disease.

Data collection and analysis: Two authors independently assessed trial quality and extracted data. Trial authors were contacted for additional information. Adverse effects data were collected from the trials.

Main results: Three trials involving 169 participants were included in the review. A limited amount of data addressing some of the primary and some of the secondary outcomes were provided, but data were incomplete and based on un-validated assumptions used in the evaluation of outcomes. One trial reported a reduction in the number of pain crises and their severity with active intervention than placebo but presented no data to confirm these results. A second trial presented a monthly global pain score based on the number of sickle cell crises and severity of pain but included no separate data for these primary outcomes. Although there was no significant difference between the piracetam and placebo periods for the number of days of hospitalisation (P = 0.87) in one trial, inconsistencies in the criteria necessary for hospitalisation during sickle crises did not permit accurate conclusions to be drawn. Two of the trials reported participant satisfaction with piracetam but provided no details as to how this satisfaction had been assessed. There were no reports of toxicity or adverse effects with piracetam other than one participant who experienced dizziness.

Authors' conclusions: The small number of included trials and their poor methodological quality provided insufficient reliable evidence to support the routine use of this medication for preventing the incidence of painful sickle cell disease crises.We will continue to run searches to identify any potentially relevant trials; however, we do not plan to update other sections of the review until new trials are published.

PubMed Disclaimer

Conflict of interest statement

Amani Al Hajeri: none known.

Zbys Fedorowicz: none known.

Update of

Similar articles

See all similar articles

Cited by

References

References to studies included in this review

Alvim 2005 {published data only}
    1. Alvim RC, Viana MB, Pires MA, Franklin HM, Paula MJ, Brito AC, et al. Inefficacy of piracetam in the prevention of painful crises in children and adolescents with sickle cell disease. Acta Haematologica 2005;113(4):228-33. - PubMed
    1. Viana MB, Alvim RC. Painful crises in children with sickle cell disease are not prevented by piracetam. Acta Haematologica 2009;121(1):9-10. - PubMed
El‐Hazmi 1998 {published data only}
    1. El-Hazmi M, Al-Fawaz I, Warsy A, Opawoye A, Taleb H, Howsawi Z, et al. Piracetam for the treatment of sickle cell disease in children - a double blind test. Saudi Medical Journal 1998;19(1):22-7. - PubMed
    1. El-Hazmi MA, Warsy AS, Al-Fawaz I, Farid M, Refai S, Opawoye AO, et al. Piracetam in the treatment of sickle cell disease [abstract]. In: The National Sickle Cell Disease Program Annual Meeting Conference Proceedings; 1995 March. 1995:162.
    1. El-Hazmi MA, Warsy AS, Al-Fawaz I, Opawoye AO, Abu Taleb H, Howsawi Z, et al. Piracetam is useful in the treatment of children with sickle cell disease. Acta Haematologica 1996;96(4):221-6. - PubMed
Mikati 1983 {published data only}
    1. Mikati MA, Solh HM, Deryan DE, Sahli IF, Dabbous IA. A preliminary report on piracetam in sickle cell anemia: a double-blind crossover clinical trial and effects on erythrocyte survival. The King Faisal Specialist Hospital Medical Journal 1983;3(4):233-6.

References to studies excluded from this review

De Araujo 1977 {published data only}
    1. De Araujo JT, Nero GS. Piracetam and acetamide in sickle-cell disease. Lancet 1977;2(8034):411. - PubMed
De Melo 1976 {published data only}
    1. De Melo GO. Piracetam in sickle cell anaemia. Lancet 1976;2(7995):1139. - PubMed
Franklin 1980 {published data only}
    1. Franklin IM. Piracetam in sickle cell disease. Lancet 1980;1(8143):767. - PubMed
Gini 1987 {published data only}
    1. Gini EK, Sonnet J. Use of piracetam improves sickle cell deformability in vivo. Journal of Clinical Pathology 1987;40(1):99-102. - PMC - PubMed
Sonnet 1985 {published data only}
    1. Sonnet J, Gini EK, Cornu G. Trial prevention of vaso-occlusive crises in homozygote in sickle cell anemia using piracetam [Essai de prevention des crises vaso-occlusives de la drepanocytose homozygote par le piracetam]. Annales de la Société belge de médecine tropicale 1985;65(1):77-84. - PubMed

Additional references

Al‐Arrayed 1995
    1. Al-Arrayed SS, Haites N. Features of sickle-cell disease in Bahrain. Eastern Mediterranean Health Journal 1995;1(1):112-9.
Asakura 1981
    1. Asakura T, Ohnishi ST, Adachi K, Ozguc M, Hashimoto K, Devlin MT, et al. Effect of piracetam on sickle erythrocytes and sickle hemoglobin. Biochimica et Biophysica Acta 1981;668(3):397-405. - PubMed
Balkaran 1992
    1. Balkaran B, Char G, Morris JS, Serjeant BE, Serjeant GR. Stroke in a cohort study of patients with homozygous sickle cell disease. Journal of Pediatrics 1992;120(3):360-6. - PubMed
Brozovic 1987
    1. Brozovic M, Davies SC. Management of sickle cell disease. Postgraduate Medical Journal 1987;63(742):605-9. - PMC - PubMed
Castro 1994
    1. Castro O, Brambilla DJ, Thorington B, Reindorf CA, Scott RB, Gillette P, et al. The acute chest syndrome in sickle cell disease: incidence and risk factors. Blood 1994;84(2):643-9. - PubMed
Davies 1997
    1. Davies SC, Oni L. The management of patients with sickle cell disease. BMJ 1997;315(7109):656-60. - PMC - PubMed
Davies 2004
    1. Davies EG, Riddington C, Lottenberg R, Dower N. Pneumococcal vaccines for sickle cell disease. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No: CD003885. [DOI: 10.1002/14651858.CD003885.pub2] - DOI - PMC - PubMed
de Araujo 1977
    1. Araujo JT, Nero GS. Piracetam and acetamide in sickle-cell disease. Lancet 1977;2(8034):411. - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-9. - PubMed
El‐Hazmi 1990
    1. El-Hazmi MA, Bahakim HM, al-Swailem AM, Warsy AS. The features of sickle cell disease in Saudi children. Journal of Tropical Pediatrics 1990;36(4):148-55. - PubMed
El‐Hazmi 1992
    1. El-Hazmi MAF, Warsy AS, Al Momen AK, Harakati M. Hydroxyurea for the treatment of sickle cell disease. Acta Haematologica 1992;88(4):170-4. - PubMed
Goldberg 1958
    1. Goldberg CAJ. A new method for starch gel electrophoresis with special reference to the determination of hemoglobin A2. Clinical Chemistry 1958;4:484. - PubMed
Higgins 2005
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. In: The Cochrane Library. The Cochrane Collaboration. Chichester, UK: John Wiley & Sons, Ltd; 2005, Issue 3. 2005.
Jones 2001
    1. Jones AP, Davies S, Olujohungbe A. Hydroxyurea for sickle cell disease. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No: CD002202. [DOI: 10.1002/14651858.CD002202] - DOI - PubMed
Knight 1995
    1. Knight S, Singhal A, Thomads P, Serjeant GR. Factors associated with lowered intelligence in homozygous sickle cell disease. Archives of Disease in Childhood 1995;73(4):316-20. - PMC - PubMed
Moriau 1993
    1. Moriau M, Crasborn L, Lavenne-Pardonge E, Frenckell R, Col-Debeys C. Platelet anti-aggregant and rheological properties of piracetam. A pharmacodynamic study in normal subjects. Arzneimittelforschung 1993;43(2):110-8. - PubMed
NIH 2002
    1. National Institutes of Health National Heart, Lung and Blood Institute. The Management of Sickle Cell Disease. NIH Publication No. 02-2117 2002.
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Serjeant 1994
    1. Serjeant GR. The geography of sickle-cell disease: opportunity for understanding its diversity. Annals of Saudi Medicine 1994;14:237-46. - PubMed
Serjeant 2001
    1. Serjeant GR, Serjeant BE. Sickle Cell Disease. 3rd edition. Oxford: Oxford University Press, 2001.
Topley 1981
    1. Topley JM, Rogers DW, Stevens MC, Serjeant GR. Acute splenic sequestration and hypersplenism in the 5 years of life in homozygous sickle cell disease. Archives of Disease in Childhood 1981;56(10):765-9. - PMC - PubMed
Vernon 1991
    1. Vernon MW, Sorkin EM. Piracetam. An overview of its pharmacological properties and a review of its therapeutic use in senile cognitive disorders. Drugs and Aging 1991;1(1):17-35. - PubMed
WHO 2006
    1. World Health Organization. Sickle-cell anaemia. Report A59/9. Provisional agenda item 11.4. 59th World Health Assembly. www.who.int/gb/ebwha/pdf_files/WHA59/A59_9-en.pdf (accessed 15 February 2006).

Publication types

LinkOut - more resources