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. (4th February 2021)

• Record Type: Journal Article
• Authors: Botti, Renée-Paule; Bokoum, Sie Saïda; L'Hermite, Etienne; Silue, Dohoma Alexis; Kouakou, Boidy; Bognini, Sarah Anastasie; Agoua, Serge Arnaud; Mandeng Ma Linwa, Edgar; Ayemou, Roméo; Koffi, Kouassi Gustave
• Other Names: Vesole David H. Academic Editor.
• Is Part Of: Advances in hematology. Volume 2021(2021)
• Publication Date: 2021-02-04
• Subjects: Hematology -- Periodicals; Hematologic Diseases; Hematology; Hematology; Periodicals; Periodicals; 616.15
• DOI: 10.1155/2021/1373754
• Languages: English
• ISSNs: 1687-9104

Abstract

Abstract : 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.