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Trial Shows L-Glutamine Leads to Fewer Instances of Sickle Cell-Related Pain

This oral therapy reduces oxidative stress, allowing fewer pain episodes

A PPM Brief

Researchers recently tested1 the efficacy of pharmaceutical-grade l-glutamine, an oral therapy shown to increase the proportion of the reduced form of nicotinamide adenine dinucleotides in sickle cell erythrocytes, for the reduction of oxidative stress leading to fewer episodes of sickle cell-related pain. Results found that among patients with sickle cell anemia, the median number of pain crises over 48 weeks was lower among those who received l-glutamine alone or with hydroxyurea treatment, compared to those who received placebo with or without hydroxyurea treatment.

This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial tested l-glutamine (0.3 g per kilogram of body weight per dose) administered twice daily by mouth, as compared with placebo, in reducing the incidence of pain crises among patients with sickle cell anemia or sickle β0-thalassemia, as well as a history of two or more pain crises during the previous year. Patients receiving hydroxyurea treatment at a stable dose for at least 3 months before screening continued their therapy through the 48-week treatment period.

A total of 230 patients (5 to 58 years, 53.9% female) were randomly assigned (2:1) to receive l-glutamine (152 patients) or placebo (78 patients). Two-thirds of the patients in both groups also received concomitant hydroxyurea treatment. The l-glutamine group had significantly fewer pain crises than those in the placebo group (p = 0.005), with a median of 3.0 to 4.0, respectively. Also, fewer hospitalizations occurred in the l-glutamine group compared to the placebo group (p = 0.005), with a median of 2.0 to 3.0, respectively. Adverse effects occurring more frequently in the l-glutamine group included minor nausea, chest pain, fatigue, and musculoskeletal pain.

Last updated on: February 4, 2020
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Pain Management Dilemmas of Sickle Cell Disease
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