Summary
A randomized double-blind clinical trial was performed to test the safety and efficacy
of a low-molecular-weight heparin, tinzaparin (Innohep®), for the management of acute painful vasoocclusive crisis characteristic of sickle
cell anemia (SCA). We studied 253 patients with acute painful crisis but with no other
complications of SCA, randomized to treatment or control groups. In the treatment
group, 127 patients received tinzaparin at 175 IU/kg, subcutaneous once daily, along
with supportive care including morphine analgesia; in the control group, 126 patients
received placebo and the same supportive care.The maxi- mal experimental treatment
period was seven days. Analysis revealed a statistically significant reduction in
number of days with the severest pain score, overall duration of painful crisis, and
duration of hospitalization (p <0.05 for each comparison of tinzaparin vs. placebo).The
decline in pain intensity was sharper for tinzaparin-treated patients, and complications
consisted of two minor bleeding events that were reported and treated by cessation
of tinzaparin.This investigation demonstrated that tinzaparin, administered at its
approved treatment regimen, reduced the severity and duration of acute crisis of SCA.
Keywords
Sickle cell anemia - tinzaparin - heparin - pain - genetic disease