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A comparison of the mixed and sequential use of acetaminophen and dexketoprofen in painful vaso-occlusive crises

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Abstract

Purpose

Opioids are widely used to treat painful vaso-occlusive crises (VOC) in sickle cell disease (SCD). However, due to opioids’ significant adverse effect profiles, the search for alternative therapies continues from the past to the present. The study aimed to investigate the efficacy of acetaminophen and dexketoprofen in the treatment of painful VOC.

Methods

This study is a single-center, prospective, non-randomized, single-blinded, controlled study. The study comprised two groups: the first administered acetaminophen and dexketoprofen mixed group, while the second received them sequential group. Opioids were used in patients with persistent pain despite these analgesics. Demographic and laboratory information, pain scores, opioid requirement, dose amount, side effects, and length of hospital stay of the patients were recorded.

Results

The study comprised 56 (100%) patients with painful VOC, 29 (51.8%) from the mixed group, and 27 (48.2%) from the sequential group. Opioid use was seen in 16 (55.2%) patients in the mixed group and 21 (77.8%) patients in the sequential group (p = 0.074). The median amount of opioid used was significantly lower in the mixed group than in the sequential group (p < 0.001). Also, the median length of hospital stay was significantly lower in the mixed group than in the sequential group (p < 0.001).

Conclusion

Our study suggests that administering acetaminophen and dexketoprofen in the mix for the treatment of painful VOC in patients with SCD may be a more efficient approach compared to sequential administration. This approach appears to reduce opioid usage and shorten hospital stays.

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Data availability

No datasets were generated or analysed during the current study.

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Authors and Affiliations

  1. Department of Hematology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey

    Murat Kaçmaz

  2. Department of Hematology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey

    Gül İlhan

Authors
  1. Murat Kaçmaz
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  2. Gül İlhan
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Contributions

Conceptualization; Murat Kaçmaz, Gül İlhan Data curation; Murat Kaçmaz Formal analysis; Murat Kaçmaz Investigation; Murat Kaçmaz, Gül İlhan Methodology; Murat ; Murat Kaçmaz Supervision; Gül İlhan Roles/Writing-original draft; Murat Kaçmaz Writing-review & editing; Gül İlhan.

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Correspondence to Murat Kaçmaz.

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Kaçmaz, M., İlhan, G. A comparison of the mixed and sequential use of acetaminophen and dexketoprofen in painful vaso-occlusive crises. Eur J Clin Pharmacol 80, 475–480 (2024). https://doi.org/10.1007/s00228-024-03630-8

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  • DOI: https://doi.org/10.1007/s00228-024-03630-8

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