Spectra Optia for automatic red blood cell exchange in people with sickle cell disease

The committee concluded that Spectra Optia is effective for red blood cell exchange in managing sickle cell disease. It noted that automated exchange with Spectra Optia is needed less frequently and is quicker than manual exchange. The committee noted that automated exchange is considered by experts to be the only reliably iron-neutral transfusion therapy available, and that this is particularly important because chelation therapy is costly and poorly tolerated. Using Spectra Optia in patients with iron overload will not increase serum ferritin levels, and may decrease levels with prolonged treatment.

Using Spectra Optia is likely to result in significant cost savings in most patients with sickle cell disease. There are uncertainties in the cost model because of the absence of robust published data estimates for some outcome measures, and the need to incorporate qualitative information advised by experts. Cost savings may be maximised through device‑sharing schemes and by avoiding iron overload and the subsequent use of chelation therapy.

The committee noted the need for high-quality clinical data collection on the outcomes of treatment with this technology. In particular, long‑term data are needed on how automated and manual exchange affects iron overload status and the subsequent need for chelation therapy. These data could be used to address the residual uncertainties about the use of Spectra Optia.