Buprenorphine for Children and Adolescents with Sickle Cell Disease: A Scoping Review

TL;DR

This review finds limited but promising evidence that buprenorphine may help manage pain in children with sickle cell disease, though more research is needed.

Contribution

The study provides a systematic review of buprenorphine's use in pediatric sickle cell pain management, highlighting gaps in current evidence.

Findings

Published literature on buprenorphine for pediatric sickle cell pain is low quality and limited.

Small studies suggest buprenorphine may offer effective pain control with fewer side effects than traditional opioids.

More research is needed to develop pediatric-specific guidelines for buprenorphine use in this population.

Abstract

What are the main findings?
There is limited pediatric specific data on the use of buprenorphine for managing sickle cell pain.Despite this limitation, there is growing interest in this medication, and small studies have shown it is effective for pain control and may potentially have an improved side-effect profile over full agonist μ-opioids.

There is limited pediatric specific data on the use of buprenorphine for managing sickle cell pain.

Despite this limitation, there is growing interest in this medication, and small studies have shown it is effective for pain control and may potentially have an improved side-effect profile over full agonist μ-opioids.

What are the implications of the main findings?
Further studies are required to understand the use and utility of buprenorphine for pediatric patients with sickle cell disease.Creation of guidelines for use of buprenorphine for children with sickle cell disease may expand use.

Further studies are required to understand the use and utility of buprenorphine for pediatric patients with sickle cell disease.

Creation of guidelines for use of buprenorphine for children with sickle cell disease may expand use.

Background and Objective: Sickle cell disease (SCD) is an inherited blood disorder associated with recurrent painful crises. Sickle cell pain crises are a significant source of distress for patients and contribute substantially to hospital utilization among SCD populations. Many children with SCD also experience chronic pain, which is often multifactorial in nature. The management of both acute and chronic pain in SCD commonly relies on opioid medications. Acute and chronic use of opioids is associated with health risks and potential complications, which has raised interest in alternatives. Buprenorphine is a partial μ-receptor agonist with strong affinity that confers pain relief and may have an improved side-effect profile. While there is emerging evidence for its use in adult patients, the data is less developed in pediatrics. Methods: A scoping review was designed in accordance with PRISMA guidelines to systematically explore the literature on buprenorphine use in pain management for children with sickle cell disease (SCD). Results: This review shows that the published literature in this area is of low quality and extremely limited, and there is a lack of trials specifically designed to address the use of buprenorphine for this patient population. Studies are limited in their generalizability but suggest that buprenorphine may be useful in managing pain in this population. Conclusions: While promising, more data is required both retrospectively and prospectively to understand the utility of buprenorphine. The development of pediatric-specific protocols for transitioning from full µ-receptor agonist opioids to buprenorphine is also needed.

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