We reviewed the evidence about the effect and safety of phytomedicines in people with sickle cell disease of all types, of any age, in any setting.
Sickle cell disease is an inherited blood condition caused by defects in the production of haemoglobin. Haemoglobin is the part of the red blood cell that carries oxygen across the body. Sickle cell disease occurs when people inherit faulty genes responsible for producing haemoglobin from both parents. A variety of complications and a reduced life expectancy are linked with sickle cell disease. Phytomedicines are medicines derived from plants in their original state. People with sickle cell disease may come across them in terms of plant-remedies from traditional healers. Their benefits have not been evaluated systematically. Laboratory work has long suggested that these medicines may help to ease the symptoms of sickle cell disease.
The evidence is current to: 24 August 2017.
Two trials (182 participants) and two phytomedicines Niprisan® (also known as Nicosan®) and Ciklavit® were included.
This review found that Niprisan® may help to reduce episodes of sickle cell disease crises associated with severe pain. Ciklavit®, which has been reported to reduce painful crises in people with sickle cell disease, deserves further study before recommendations can be made regarding its use. The trial of Ciklavit® also reported a possible adverse effect on the level of anaemia. Both formulations reported no serious adverse symptoms or derangement of liver or kidney function in the participants. More detailed and larger trials of these medicines will need to be carried out before we can make any recommendations about their use. Further research should also assess long-term outcome measures.
Quality of the evidence
We judged the quality of the evidence from this review to be of low to very low quality, depending on the outcome measured.