title: Clinical response of patients with sickle cell anemia to cromolyn sodium nasal spray.
abstract: Sickle cell anemia is the most common heritable hematological disease affecting humans. Although hydroxyurea is the most commonly used antisickling agent, several previous studies suggest that cromolyn sodium also prevents sickling when administered acutely. However, no previous studies have evaluated the safety or efficacy of prolonged administration of cromolyn to patients with sickle cell anemia. The purpose of this study, therefore, was to test the hypothesis that prolonged administration of cromolyn alone or in combination with hydroxyurea would decrease the incidence of pain crises and/or alter the chronic pain seen in patients with this disease. In this crossover, single-blind, in vivo and in vitro study, 17 patients with sickle cell disease were studied. Each patient had to fill out a standard pain chart. Every 3 months the patients' medications changed in the following manner: The first 3 months the patients used cromolyn sodium nasal spray; the second 3 months they received placebo nasal spray; the third 3 months they received cromolyn sodium nasal spray and hydroxyurea capsule; and the last 3 months they received hydroxyurea capsule and placebo nasal spray. The least pain was felt with the mixture of hydroxyurea capsule and cromolyn sodium nasal inhaler. Furthermore, with the other combinations of medications, there were no significant statistical changes in the number of sickled red blood cells. Every combination used in this survey had positive effects on decreasing the pain. cromolyn sodium nasal spray is significantly efficient in decreasing sickle cell crisis as well as pain intensity in patients with sickle cell anemia.
authors.affiliation: Department of Pediatrics, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. karimim@sums.ac.ir
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
authors.forename: Omid R
authors.initials: OR
authors.lastname: Zekavat
authors.forename: Sedigeh
authors.initials: S
authors.lastname: Sharifzadeh
authors.forename: Kazem
authors.initials: K
authors.lastname: Mousavizadeh
authors.forename: Kazem
authors.initials: K
authors.lastname: Mosavizadeh
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000188:drug therapy* / Q000503:physiopathology; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001803:Blood Transfusion; D002648:Child; D004205:Cromolyn Sodium / Q000008:administration & dosage* / Q000627:therapeutic use; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D010147:Pain Measurement; D016037:Single-Blind Method
chemical_list: D018927:Anti-Asthmatic Agents; D006454:Hemoglobins; D005293:Ferritins; D004205:Cromolyn Sodium; D006918:Hydroxyurea