Expert consensus on the management of infusion-related reactions (IRRs) in patients with sickle cell disease (SCD)...

Area of Science:

• Hematology
• Pharmacology
• Clinical Medicine

Background:

• Crizanlizumab, a P-selectin inhibitor, shows efficacy in reducing vaso-occlusive crises (VOCs) in sickle cell disease (SCD).
• Rare instances of severe infusion-related reactions (IRRs) occurring within 24 hours post-infusion have been reported.
• Standardized management protocols for these IRRs in SCD patients are lacking.

Purpose of the Study:

• To develop evidence-based clinical guidelines for managing infusion-related reactions (IRRs) in patients with sickle cell disease (SCD) receiving crizanlizumab.
• To provide a consensus-driven approach for evaluating and managing IRRs based on patient-specific factors.
• To enhance the safe administration of crizanlizumab in SCD management.

Main Methods:

• Utilized the RAND/University of California, Los Angeles (UCLA) modified Delphi panel method for expert consensus.
• Incorporated current literature and clinical experience to inform guideline development.
• Defined key patient characteristics influencing IRR management, including prior reaction history and symptom severity.

Main Results:

• Developed recommendations for managing IRRs based on factors such as prior history of reactions, infusion rate adjustments, patient monitoring, pain assessment, and allergic symptoms.
• Guidelines provide a structured approach to evaluating and managing IRRs in patients undergoing crizanlizumab therapy.
• Recommendations aim to differentiate IRR severity and guide appropriate clinical interventions.

Conclusions:

• The developed guidelines offer a systematic approach to managing crizanlizumab-associated IRRs in SCD patients.
• These recommendations require validation through clinical data to confirm their efficacy and refine risk stratification.
• Further research is needed to identify patients at higher risk for developing IRRs during crizanlizumab treatment.