TY - JOUR
T1 - Preliminary evidence that hydroxyurea is associated with attenuated peripheral sensitization in adults with sickle cell disease
AU - Letzen, Janelle E.
AU - Lanzkron, Sophie
AU - Bond, Kasey
AU - Carroll, Christopher Patrick
AU - Haythornthwaite, Jennifer A.
AU - Nance, Sabrina
AU - Campbell, Claudia M.
N1 - Funding Information:
This research was supported by funds from NIH R01 HL133327 (C.P.C., J.A.H.) and NIH F32 HL143941 (J.E.L.).
Publisher Copyright:
© 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Introduction:Hydroxyurea (HU) is a drug that targets the underlying pathophysiology of sickle cell disease (SCD); however, it continues to be an underutilized treatment for adults. Previous research suggests that HU treatment can result in fewer hospital contacts for acute vaso-occlusive pain crises (VOC). Hydroxyurea's impact on non-VOC pain, however, is not well established.Objectives:This study examined whether HU moderated patterns of static and dynamic pain processing and clinical pain in SCD individuals.Methods:Fifty-eight patients with SCD (N taking HU = 17) underwent quantitative sensory testing (QST) and completed twice daily symptom diaries for 12 weeks. Quantitative sensory testing established thermal threshold and tolerance, mechanical thresholds, and thermal and mechanical temporal summation of pain.Results:Groups did not differ in age, sex, or opioid use. After controlling for morphine use, QST results showed that participants taking HU had higher heat and mechanical pain thresholds (static QST measures) but not thermal and mechanical temporal summation (dynamic QST measures). Participants taking HU also reported lower VOC pain compared with SCD participants not taking HU; however, HU did not moderate non-VOC clinical pain ratings.Conclusion:Findings cautiously suggest that HU acts on pain hypersensitivity and VOC pain, rather than inhibiting pain facilitation and non-VOC pain. These differences may reflect HU's influence on peripheral rather than central sensitization. Future research is warranted to replicate these findings in a larger sample and determine whether early HU administration can prevent peripheral sensitization in SCD individuals.
AB - Introduction:Hydroxyurea (HU) is a drug that targets the underlying pathophysiology of sickle cell disease (SCD); however, it continues to be an underutilized treatment for adults. Previous research suggests that HU treatment can result in fewer hospital contacts for acute vaso-occlusive pain crises (VOC). Hydroxyurea's impact on non-VOC pain, however, is not well established.Objectives:This study examined whether HU moderated patterns of static and dynamic pain processing and clinical pain in SCD individuals.Methods:Fifty-eight patients with SCD (N taking HU = 17) underwent quantitative sensory testing (QST) and completed twice daily symptom diaries for 12 weeks. Quantitative sensory testing established thermal threshold and tolerance, mechanical thresholds, and thermal and mechanical temporal summation of pain.Results:Groups did not differ in age, sex, or opioid use. After controlling for morphine use, QST results showed that participants taking HU had higher heat and mechanical pain thresholds (static QST measures) but not thermal and mechanical temporal summation (dynamic QST measures). Participants taking HU also reported lower VOC pain compared with SCD participants not taking HU; however, HU did not moderate non-VOC clinical pain ratings.Conclusion:Findings cautiously suggest that HU acts on pain hypersensitivity and VOC pain, rather than inhibiting pain facilitation and non-VOC pain. These differences may reflect HU's influence on peripheral rather than central sensitization. Future research is warranted to replicate these findings in a larger sample and determine whether early HU administration can prevent peripheral sensitization in SCD individuals.
KW - Chronic pain
KW - Hydroxyurea
KW - Quantitative sensory testing
KW - Sickle cell disease
KW - VOC pain
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U2 - 10.1097/PR9.0000000000000724
DO - 10.1097/PR9.0000000000000724
M3 - Article
C2 - 31041423
AN - SCOPUS:85080128108
SN - 2471-2531
VL - 4
JO - Pain Reports
JF - Pain Reports
IS - 2
M1 - e724
ER -