Tapered oral dexamethasone for the acute chest syndrome of sickle cell disease

Br J Haematol. 2011 Oct;155(2):263-7. doi: 10.1111/j.1365-2141.2011.08827.x. Epub 2011 Aug 16.

Abstract

Tapered oral dexamethasone for acute chest syndrome (ACS) in sickle cell anaemia was studied using a novel ACS assessment tool and investigational biomarkers. Twelve participants were randomized (mean age 17·3 years) before early study termination. Dexamethasone decreased duration of hospitalization for ACS by 20·8 h compared to placebo (P = 0·024). Rebound pain occurred in both groups (3 dexamethasone versus 1 placebo). Overall, dexamethasone decreased the leucocyte activation biomarker, sL-selectin; however, participants with rebound pain had higher sL-selectin within 24 h of treatment (dexamethasone or placebo). This ACS assessment tool was feasibly applied, and sL-selectin is a promising biomarker of ACS therapy.

Trial registration: ClinicalTrials.gov NCT00530270.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Chest Syndrome / blood
  • Acute Chest Syndrome / drug therapy*
  • Acute Chest Syndrome / etiology
  • Acute Chest Syndrome / therapy
  • Adolescent
  • Adult
  • Anemia, Sickle Cell / complications*
  • C-Reactive Protein / analysis
  • Cell Adhesion Molecules / blood
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nitric Oxide / blood
  • Oxygen Inhalation Therapy
  • Sickle Cell Trait / complications
  • Treatment Outcome
  • Young Adult
  • beta-Thalassemia / complications

Substances

  • Cell Adhesion Molecules
  • Nitric Oxide
  • Dexamethasone
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT00530270