An attempt to discover how sickle cell disease effects the resorption and inhibition of resorption of bones. In sickle cell disease, an inherited anemia occurring almost exclusively in African Americans, blood cells are deformed and rigid causing anemia, episodes of severe bone pain, and multi-organ dysfunction. Other symptoms are joint pain, attacks of abdominal pain and ulcerations of the lower extremities. Immediate treatment of bone pain is largely limited to analgesic medications and is unsatisfactory. Episodic bone pain is presumably related to closing of blood vessels and the deficiency of blood in a body part. No routinely available lab tests have been found to be of value in monitoring the pain and its causes in the individual patient. Clinical studies of bone biochemistry in sickle cell diseases are apparently quite limited. The hypothesis is that activation of bone resorption is a component of the disorder make-up of bone pain of the sickle cell disease and that inhibition of the resorption activation by bisphosphonate treatment will reduce sickle cell anemia related bone pain. The most specific clinical indicator of resorption activity is urinary excretion of n-telopeptide. N-telopeptide is most commonly used to monitor bone resorption in patients with osteoporosis. In a first clinical study, it is proposed that the measurement of urinary n-telopeptide excretion in patients with sickle cell disease will demonstrate elevated excretion in this patient population. This will enable researchers to determine the feasibility and toxicity of bisphosphonate treatment and the evidence of therapeutic effect based on changes in n-telopeptide excretion. The patients in this study are already participating in another study (ViSCUS VANGUARD) in which they keep a diary of pain and use of pain medications. This will be a companion study to learn more about how sickle cell disease effects the bones. During the study, up to four urine samples will be donated for analysis and evidence of chemicals released during the breakdown of bone, such as may occur during sickle cell crisis. Results from the urine sample studies will be compared with reported pain symptoms and use of pain medications from the other study.
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