Treatment of Sickle Cell Pain

Karen F. Marlowe, PharmD., Michael F. Chicella, PharmD.

Disclosures

Pharmacotherapy. 2002;22(4) 

In This Article

Future Therapy Options

Although further research is needed to evaluate existing modes of therapy, most research focuses on preventive therapy. Different therapies are being investigated. Levels of the inflammatory neuropeptide substance P are elevated in patients with sickle cell disease and increase further during pain crises. Substance P induces vaso-dilation, plasma extravasation, release of histamine from mast cells, and release of inflammatory mediators such as interleukins and tumor necrosis factor. Therefore, neurokinin antagonists may have a role in treating or preventing pain episodes.[51] Phase III trials have been completed for poloxamer 188 (Flocor; CytRx Corp., Atlanta, GA), which decreases length of crises by improving microvascular blood flow.[52] In addition, effects of leukotriene antagonists on frequency and severity of pain crises are under investigation (Haynes J, College of Medicine Research Office, University of South Alabama, Mobile, AL, personal communication, July 2001).

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