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Monitoring: Consider periodic testosterone and estradiol testing HCG can increase estradiol conversion in some individuals

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Rarely, allergic reactions like itching or rash can occur, and excessive or prolonged use may strain the kidneys or liver, especially in those with pre-existing conditions

Abbreviations SCD: Sickle cell diseases RBC: Red blood cells WHO: World Health Organization HPLC: High-performance liquid chromatography RNA: Ribonucleic acid ERK12: Extracellular signal-regulated protein kinase DNA: Deoxynucleic acid WBC: White blood cells AUC: Area under curve Cmax: Maximum concentration Hb: Hemoglobin TEAEs: Treatment-emergent adverse event FDA: Food and drug administration ICER: Institution for clinical and economic review HU: Hydroxyurea EMEA: European medical agency cGMP: Cyclic GMP VOC: Vaso-occlusive crisis NAD: Nicotinamide adenine dinucleotide BMT: Bone marrow transplant GVHD: Graft versus host disease HLA: Human leukocyte antigen ADP: Adenosine diphosphate References Lagunju I, Brown BJ, Oyinlade AO et al (2019) Annual stroke incidence in Nigerian children with sickle cell disease and elevated TCD velocities treated with hydroxyurea

What's Theoretical Almost all BPC-157 mechanism data comes from rodent and in vitro models, not human trials

The review protocol summary can be accessed at the PROSPERO website