SCD Medications Use and Pain Events Among SCD Patients in a Nigerian Hospital.

Abstract

Objective: To evaluate the relationship between analgesic use/ disease-modifying medications and the frequency of painful crises among sickle cell disease (SCD) patients in Nigeria.

Methods: A single-center, cross-sectional study was conducted among 85 SCD patients at a teaching hospital in Nigeria. Socio-demographic data, clinical parameters and the use of pain medications were obtained using a structured questionnaire through an interview process and case file review.

Results: The mean age of the subjects was 28.8 ± 10.9 years. About 57.6% of the subjects were on hydroxyurea. None of the subjects were on crinzalizumab and l-glutamine. About 36.5% have more than three painful crises in a year. There was significant association between hydroxyurea (p = .005), ciklavit (p < .001), weak opiates [tramadol/codeine] (p = .027), and pentazocine (p = .019) utilization and painful crises. Among the signs and symptoms of neuropathic pain, neuralgic pain (p = .009), tingling (0.034), and hyperesthesia (0.013) were also all significantly associated with painful crises. In the multivariate analysis, hydroxyurea (OR; 3.98), ciklavit (OR; 6.29), pentazocine (3.57) use, evidence of neuralgic pain (OR; 3.35), tingling (OR; 2.64) and hyperesthesia (OR; 10.19) were associated with painful crisis.

Conclusion: While the use of hydroxyurea is relatively acceptable, the non-use of newer therapies like l-glutamine represents low accessibility for sickle cell disease patients. Neuropathic pain can be associated with a painful crisis and should be managed too during a crisis. With Ciklavit, newer pain medications should be explored.