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Letzen JE, Lanzkron S, Bond K, et al. Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease. Pain Rep. 2019;4(2):e724doi: 10.1097/PR9.0000000000000724.
Letzen, J. E., Lanzkron, S., Bond, K., Carroll, C. P., Haythornthwaite, J. A., Nance, S., & Campbell, C. M. (2019). Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease. Pain reports, 4(2), e724. https://doi.org/10.1097/PR9.0000000000000724
Letzen, Janelle E, et al. "Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease." Pain reports vol. 4,2 (2019): e724. doi: https://doi.org/10.1097/PR9.0000000000000724
Letzen JE, Lanzkron S, Bond K, Carroll CP, Haythornthwaite JA, Nance S, Campbell CM. Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease. Pain Rep. 2019 Mar 22;4(2):e724. doi: 10.1097/PR9.0000000000000724. eCollection 2019. PMID: 31041423; PMCID: PMC6455681.
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Pain Rep. 2019 Mar 22;4(2):e724. doi: 10.1097/PR9.0000000000000724. eCollection 2019.

Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease.

Pain reports

Janelle E Letzen, Sophie Lanzkron, Kasey Bond, Christopher Patrick Carroll, Jennifer A Haythornthwaite, Sabrina Nance, Claudia M Campbell

Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  2. Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  3. Department of Hematology and Medical Oncology, New York University Langone Health, New York, NY, USA.

PMID: 31041423 PMCID: PMC6455681 DOI: 10.1097/PR9.0000000000000724

Abstract

INTRODUCTION: Hydroxyurea (HU) is a drug that targets the underlying pathophysiology of sickle cell disease (SCD); however, it continues to be an underutilized treatment for adults. Previous research suggests that HU treatment can result in fewer hospital contacts for acute vaso-occlusive pain crises (VOC). Hydroxyurea's impact on non-VOC pain, however, is not well established.

OBJECTIVES: This study examined whether HU moderated patterns of static and dynamic pain processing and clinical pain in SCD individuals.

METHODS: Fifty-eight patients with SCD (N taking HU = 17) underwent quantitative sensory testing (QST) and completed twice daily symptom diaries for 12 weeks. Quantitative sensory testing established thermal threshold and tolerance, mechanical thresholds, and thermal and mechanical temporal summation of pain.

RESULTS: Groups did not differ in age, sex, or opioid use. After controlling for morphine use, QST results showed that participants taking HU had higher heat and mechanical pain thresholds (static QST measures) but not thermal and mechanical temporal summation (dynamic QST measures). Participants taking HU also reported lower VOC pain compared with SCD participants not taking HU; however, HU did not moderate non-VOC clinical pain ratings.

CONCLUSION: Findings cautiously suggest that HU acts on pain hypersensitivity and VOC pain, rather than inhibiting pain facilitation and non-VOC pain. These differences may reflect HU's influence on peripheral rather than central sensitization. Future research is warranted to replicate these findings in a larger sample and determine whether early HU administration can prevent peripheral sensitization in SCD individuals.

Keywords: Chronic pain; Hydroxyurea; Quantitative sensory testing; Sickle cell disease; VOC pain

Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

References

  1. BMC Med Res Methodol. 2002 Jun 17;2:8 - PubMed
  2. Health Qual Life Outcomes. 2005 Aug 29;3:50 - PubMed
  3. N Engl J Med. 1990 Aug 9;323(6):366-72 - PubMed
  4. Blood. 1991 Jul 1;78(1):212-6 - PubMed
  5. J Pain. 2007 Nov;8(11):893-901 - PubMed
  6. Ann Intern Med. 2008 Jun 17;148(12):932-8 - PubMed
  7. Ann Intern Med. 2008 Jun 17;148(12):939-55 - PubMed
  8. J Pain. 2009 Jun;10(6):556-72 - PubMed
  9. J Pain. 2009 Sep;10(9):895-926 - PubMed
  10. Am J Hematol. 2010 Jun;85(6):403-8 - PubMed
  11. J Pain Symptom Manage. 2010 Sep;40(3):416-35 - PubMed
  12. Epidemiology. 1990 Jan;1(1):43-6 - PubMed
  13. Blood. 2011 Jul 7;118(1):19-27 - PubMed
  14. J Pediatr Hematol Oncol. 2011 May;33(4):251-4 - PubMed
  15. Ophthalmic Physiol Opt. 2014 Sep;34(5):502-8 - PubMed
  16. Indian J Hematol Blood Transfus. 2014 Jun;30(2):91-6 - PubMed
  17. Blood. 2014 Dec 18;124(26):3850-7; quiz 4004 - PubMed
  18. Transl Perioper Pain Med. 2015 Jul 26;2(2):8-17 - PubMed
  19. Pain. 2016 Apr;157(4):949-56 - PubMed
  20. J Pain. 2016 May;17(5):617-27 - PubMed
  21. Am J Prev Med. 2016 Jul;51(1 Suppl 1):S69-77 - PubMed
  22. J Pain. 2016 Nov;17(11):1227-1236 - PubMed
  23. Am J Hematol. 1989 Oct;32(2):104-11 - PubMed
  24. J Pain. 2017 May;18(5):490-498 - PubMed
  25. Pain. 2017 Apr;158 Suppl 1:S79-S84 - PubMed
  26. Eur J Haematol. 2017 Jun;98(6):608-614 - PubMed
  27. Scand J Pain. 2017 Oct;17:279-286 - PubMed
  28. Blood. 2017 Nov 30;130(22):2377-2385 - PubMed
  29. Am J Physiol Regul Integr Comp Physiol. 2018 Jul 1;315(1):R104-R112 - PubMed
  30. Science. 1986 Apr 18;232(4748):388-90 - PubMed
  31. N Engl J Med. 1995 May 18;332(20):1317-22 - PubMed
  32. Blood. 1994 Jan 15;83(2):553-60 - PubMed

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