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Trial of low doses of aspirin as prophylaxis in sickle cell disease
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Low-dose aspirin did not reduce painful crises in children with sickle hemoglobinopathies. This study suggests platelets may not be involved in sickle cell vaso-occlusive events.
Area of Science:
- Pediatrics
- Hematology
- Pharmacology
Background:
- Sickle hemoglobinopathies cause painful vaso-occlusive crises.
- Aspirin affects platelet function, potentially impacting these crises.
Purpose of the Study:
- To evaluate low-dose aspirin's effect on painful crisis frequency and severity in children with sickle hemoglobinopathies.
Main Methods:
- A double-blind, placebo-controlled crossover study.
- 49 pediatric patients with sickle hemoglobinopathies were monitored.
- Painful crises were recorded over 21 months.
Main Results:
- No significant difference in crisis frequency or severity was observed between aspirin and placebo groups.
- Patients experienced an average of 1.1 painful crises per year.
- 70% had up to two crises, 25% had four or more.
Conclusions:
- Low-dose aspirin therapy did not alter the frequency or severity of painful crises.
- Findings suggest platelets may not initiate or progress the vaso-occlusive process in sickle cell disease.
Abstract:
The effects of low doses of aspirin on the frequency and severity of painful vaso-occlusive crises were evaluated in children with sickle hemoglobinopathies. Aspirin was compared with placebo in 49 patients in a double-blind crossover study. Careful monitoring of patients revealed an average of 1.1 painful crises per patient year. During the 21 months of study, 70% of patients had a maximum of two painful crises, and 25% experienced four or more. The frequency and severity of crises were not affected by aspirin therapy. In view of aspirin's demonstrated effect on platelet function, we suggest that platelets do not contribute to the initiation or progression of the vaso-occlusive process.