Journal Article

A Multinational Trial of Prasugrel for Sickle Cell Vaso-Occlusive Events

Heath, Lori E, Robitaille, Nancy, Nduba, Videlis N, Jakubowski, Joseph A, Colombatti, Raffaella, Ogutu, Bernhards, Brown, Patricia B, Hassab, Hoda M, Abboud, Miguel R, Agbenyega, Tsiri, Heeney, Matthew M, Segbefia, Catherine I, Rees, David C, Oyieko, Janet N, Zamoryakhin, Dmitry, Inusa, Baba, Zhou, Chunmei, Hoppe, Carolyn C, Kanter, Julie

2016

Overview

In an effort to reduce the rate of sickle cell crises and acute chest syndrome, a trial compared prasugrel with placebo in patients 2 through 17 years of age who had sickle cell anemia. Prasugrel did not have a significant effect on the rate of vaso-occlusive crises. Sickle cell anemia, which is estimated to affect 100 million persons worldwide, is an inherited blood disorder characterized by hemolytic anemia and recurrent vaso-occlusive crises that are associated with hospitalizations, impaired quality of life, and early death. 1 – 3 The pathophysiological mechanism of vaso-occlusion in sickle cell anemia is complex. The polymerization of sickle hemoglobin initiates a cascade of thrombotic and inflammatory insults that result in progressive vascular damage and ischemic end-organ injury. 4 Hydroxyurea is partially effective in reducing the frequency of acute vaso-occlusive events, but it has not been shown to prevent organ damage. 5 There is an unmet need for . . .

• Publisher: Massachusetts Medical Society
• Subject: Acute Chest Syndrome - etiology / Acute Chest Syndrome - prevention & control / Administration, Oral / Adolescent / Adolescents / Anemia / Anemia, Sickle Cell - complications / Anemia, Sickle Cell - drug therapy / Antiplatelet therapy / Blood platelets / Cell adhesion / Child / Child, Preschool / Children / Clinical trials / Double-Blind Method / Drug therapy / Female / Hemorrhage / Hemorrhage - chemically induced / Humans / Male / Occlusion / Pain / Pain - etiology / Pain - prevention & control / Patients / Peripheral Vascular Diseases - etiology / Peripheral Vascular Diseases - prevention & control / Platelet Aggregation Inhibitors - adverse effects / Platelet Aggregation Inhibitors - therapeutic use / Prasugrel Hydrochloride - adverse effects / Prasugrel Hydrochloride - therapeutic use / Sickle cell anemia / Sickle cell disease / Thrombosis