Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast
Background. Vaso-occlusive crisis (VOC) is the primary cause of hospitalization in patients with sickle cell disease. Treatment mainly consists of intravenous morphine or nonsteroidal anti-inflammatory drugs (NSAIDs), which have many dose-related side effects. The question arises as to whether vascu...
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Wiley
2021-01-01
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| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2021/1373754 |
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| author | Renée-Paule Botti Sie Saïda Bokoum Etienne L’Hermite Dohoma Alexis Silue Boidy Kouakou Sarah Anastasie Bognini Serge Arnaud Agoua Edgar Mandeng Ma Linwa Roméo Ayemou Kouassi Gustave Koffi |
| author_facet | Renée-Paule Botti Sie Saïda Bokoum Etienne L’Hermite Dohoma Alexis Silue Boidy Kouakou Sarah Anastasie Bognini Serge Arnaud Agoua Edgar Mandeng Ma Linwa Roméo Ayemou Kouassi Gustave Koffi |
| author_sort | Renée-Paule Botti |
| collection | DOAJ |
| description | Background. Vaso-occlusive crisis (VOC) is the primary cause of hospitalization in patients with sickle cell disease. Treatment mainly consists of intravenous morphine or nonsteroidal anti-inflammatory drugs (NSAIDs), which have many dose-related side effects. The question arises as to whether vascular electrical stimulation therapy (VEST) could be effective or not on VOCs. Objective. To measure the effectiveness and safety of VEST in reducing the median time spent in severe VOC. Methods. We conducted a phase II, single blinded, randomized, controlled, triple-arm, comparative trial. We included thirty (30) adult patients with severe vaso-occlusive crisis. The study arms were divided as follows: our control group (group 0) constituted of 10 patients followed with conventional therapy (Analgesics + Hydration + NSAIDs), while 20 patients were divided equally into two interventional arms—10 patients followed with VEST + Analgesics + Hydration (group 1) and the other 10 patients followed with VEST + Analgesics + Hydration + NSAIDs (group 2). The primary efficacy endpoint was median time to severe crisis elimination. The secondary end points were median time to end-of-crisis, median tramadol consumption, progress of the haemoglobin level over 3 days, side effects, and treatment failure. Results. The age ranged from 14 to 37 years, including 23 women. We noted a beneficial influence of the VEST on the median time to severe crisis (VAS greater than 2) elimination; 17 hours (group 1) against 3.5 hours (group 2) p=0.0166 and 4 hours (group 3) with p value = 0.0448. Similar significant results were obtained on the diminution of total duration of the crisis (VAS over 0) and median tramadol consumption in patients in the interventional arms. Conclusion. These statistically significant results in the interventional arms suggest that VEST could be an alternative treatment of VOC in sickle cell patients. |
| format | Article |
| id | doaj-art-5284888f7eff4ef5904528f86312ebff |
| institution | Kabale University |
| issn | 1687-9104 1687-9112 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Advances in Hematology |
| spelling | doaj-art-5284888f7eff4ef5904528f86312ebff2025-02-03T06:47:02ZengWileyAdvances in Hematology1687-91041687-91122021-01-01202110.1155/2021/13737541373754Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory CoastRenée-Paule Botti0Sie Saïda Bokoum1Etienne L’Hermite2Dohoma Alexis Silue3Boidy Kouakou4Sarah Anastasie Bognini5Serge Arnaud Agoua6Edgar Mandeng Ma Linwa7Roméo Ayemou8Kouassi Gustave Koffi9Clinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireDiavein SAS, 227 Rte de La Chapelle, 74540 St Felix, FranceClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireFaculty of Health Sciences, University of Buea, Buea, CameroonClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireClinical Hematology Unit, CHU de Yopougon, BP 3709 Abidjan 08, Abidjan, Côte d’IvoireBackground. Vaso-occlusive crisis (VOC) is the primary cause of hospitalization in patients with sickle cell disease. Treatment mainly consists of intravenous morphine or nonsteroidal anti-inflammatory drugs (NSAIDs), which have many dose-related side effects. The question arises as to whether vascular electrical stimulation therapy (VEST) could be effective or not on VOCs. Objective. To measure the effectiveness and safety of VEST in reducing the median time spent in severe VOC. Methods. We conducted a phase II, single blinded, randomized, controlled, triple-arm, comparative trial. We included thirty (30) adult patients with severe vaso-occlusive crisis. The study arms were divided as follows: our control group (group 0) constituted of 10 patients followed with conventional therapy (Analgesics + Hydration + NSAIDs), while 20 patients were divided equally into two interventional arms—10 patients followed with VEST + Analgesics + Hydration (group 1) and the other 10 patients followed with VEST + Analgesics + Hydration + NSAIDs (group 2). The primary efficacy endpoint was median time to severe crisis elimination. The secondary end points were median time to end-of-crisis, median tramadol consumption, progress of the haemoglobin level over 3 days, side effects, and treatment failure. Results. The age ranged from 14 to 37 years, including 23 women. We noted a beneficial influence of the VEST on the median time to severe crisis (VAS greater than 2) elimination; 17 hours (group 1) against 3.5 hours (group 2) p=0.0166 and 4 hours (group 3) with p value = 0.0448. Similar significant results were obtained on the diminution of total duration of the crisis (VAS over 0) and median tramadol consumption in patients in the interventional arms. Conclusion. These statistically significant results in the interventional arms suggest that VEST could be an alternative treatment of VOC in sickle cell patients.http://dx.doi.org/10.1155/2021/1373754 |
| spellingShingle | Renée-Paule Botti Sie Saïda Bokoum Etienne L’Hermite Dohoma Alexis Silue Boidy Kouakou Sarah Anastasie Bognini Serge Arnaud Agoua Edgar Mandeng Ma Linwa Roméo Ayemou Kouassi Gustave Koffi Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast Advances in Hematology |
| title | Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast |
| title_full | Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast |
| title_fullStr | Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast |
| title_full_unstemmed | Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast |
| title_short | Efficacy and Tolerance of Vascular Electrical Stimulation Therapy in the Management of Vaso-Occlusive Crises in Patients with Sickle Cell Disease: A Phase II Single-Centre Randomized Study in Ivory Coast |
| title_sort | efficacy and tolerance of vascular electrical stimulation therapy in the management of vaso occlusive crises in patients with sickle cell disease a phase ii single centre randomized study in ivory coast |
| url | http://dx.doi.org/10.1155/2021/1373754 |
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