Sickle Cell Disease among Blacks; the Possible Pivotal Role of Precision Medicine: A Focused Review on Management of Pain

Abstract

Sickle Cell Disease (SCD) occurs commonly in sub- Saharan African region. For instance, out of the estimated 305,800 babies born annually with SCD worldwide about 75% occurred in sub-Saharan Africa (SSA). Vasoocclusive painful crisis is the prototype clinical event among SCD patients with nearly all SCD persons experiencing the episode during their lifetime. Additionally, acute vasooculusive pain crises may eventually progressed to chronic pain, resulting in poor quality of life associated with other morbidities, including anxiety, depression and dependence on pain medications. Transformation and technological development that brought about new clinical approaches and treatments have increased rates of survival in patients with Sickle Cell Disease (SCD). However, the overall life expectancy of such patients remains shorter than other normal populations. Therefore, management of pain should be guided by an individualized précised prescribing and monitoring protocol. To this end, the concept of precision medicine that is predicated on using practical application of human genomics provide an evolving set of translational research goals in the management of pain in sickle cell disease. This review tend to shed light on this new concept, hoping that the review will facilitate improved and more accessible care for all patients leaving with sickle cell disease.

Keywords: Sickle cell disease, Precision medicine, Pain management, Sickle cell crisis, Hydroxyurea.