Status:

TERMINATED

Ketorolac Versus Ibuprofen to Treat Painful Episodes of Sickle Cell Disease

Lead Sponsor:

Children's Hospital Medical Center, Cincinnati

Collaborating Sponsors:

National Heart, Lung, and Blood Institute (NHLBI)

University of Texas Southwestern Medical Center

Conditions:

Hematologic Diseases

Anemia, Sickle Cell

Eligibility:

All Genders

6-18 years

Phase:

PHASE4

Brief Summary

The purpose of this study is to compare ketorolac, a potent, non-steroidal anti-inflammatory drug (NSAID), with ibuprofen, a commonly used NSAID, for the treatment of the painful crisis of sickle cell...

Detailed Description

BACKGROUND: SCD is a common disorder among African Americans and other minority groups. It is characterized by chronic anemia and episodic vaso-occlusive crises. The most common of these crises is th...

Eligibility Criteria

Inclusion

  • Confirmed diagnosis of any form of SCD, including sickle cell anemia, sickle-hemoglobin C disease, and sickle-ß˖ or ß°-thalassemia
  • Currently experiencing an acute painful episode (vaso-occlusive crisis), defined as acute pain in the extremities, back, abdomen, or chest that has lasted at least 4 hours and is presumed to be due to SCD, with no other identified cause
  • Onset of severe pain in its current location(s) must have occurred within 72 hours of study entry
  • Intensity of pain must be great enough to necessitate hospitalization for opioid analgesia (e.g., failure of home and outpatient therapy)
  • Ability to comprehend and use patient-controlled analgesia (PCA)
  • Score of 6 or greater on the baseline pain scale

Exclusion

  • Temperature greater than or equal to 38.5ºC at the time of study entry or in the preceding 12 hours
  • Has a new lobar pulmonary infiltrate or a diagnosis of acute chest syndrome (i.e., a new lobar pulmonary infiltrate and two or more of the following: temperature greater than 38ºC, tachypnea, dyspnea, intercostal or supraclavicular retractions, nasal flaring, chest wall pain, and an oxygen saturation of less than 90% in room air by pulse oximetry)
  • Diagnosis of acute splenic or hepatic sequestration crisis (i.e., liver or spleen enlarged from steady-state size and Hgb level decreased 2 g/dL or more from steady-state value)
  • Currently experiencing priapism
  • Pain caused by suspected or confirmed hepatobiliary disease (e.g., cholecystitis or cholelithiasis)
  • Chronic pain caused by suspected or confirmed aseptic or avascular necrosis of the femoral or humeral heads
  • Chronic pain syndrome characterized by opioid tolerance and defined by hospitalization for at least 30 days for the management of pain in a 1 year period prior to study entry
  • Current participation (last transfusion given within the 2 months prior to study entry) in a program of chronic transfusions for the management of SCD; the use of hydroxyurea alone is permitted
  • Allergy or history of anaphylactoid reactions to aspirin or other NSAIDs
  • Kidney dysfunction (i.e., serum creatinine concentration greater than 1.5 times the upper limit of normal for age)
  • History of gastrointestinal bleeding or ulceration requiring medical therapy
  • Concomitant bleeding disorder (e.g., von Willebrand disease, hemophilia, or a qualitative platelet defect)
  • Any other medical condition that would make it unsafe to receive NSAIDs, as determined by the study physician
  • PCA not preferred
  • Use of ketorolac in the 30 days prior to study entry
  • Use of scheduled (e.g., "around the clock") opioid analgesics in the 5 days before the onset of current acute painful crisis
  • Pregnant

Key Trial Info

Start Date :

January 1 2005

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 1 2008

Estimated Enrollment :

10 Patients enrolled

Trial Details

Trial ID

NCT00115336

Start Date

January 1 2005

End Date

December 1 2008

Last Update

October 8 2020

Active Locations (1)

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University of Texas Southwestern Medical Center

Dallas, Texas, United States, 75390