{"doi":"10.1002/ajh.26028","title":"Randomized control trial of oral arginine therapy for children with sickle cell anemia hospitalized for pain in <scp>Nigeria</scp>","abstract":"Low arginine bioavailability is associated with vaso-occlusive painful crisis (VOC) severity in sickle cell anemia (SCA) and predicts need for pediatric hospitalization. Intravenous arginine therapy has opioid-sparing effects and was found to significantly decrease pain scores in children hospitalized with SCA-VOC in a phase-two randomized placebo-controlled trial (RCT). Efficacy of oral arginine is unknown. Our objective was to determine the safety and efficacy of oral arginine therapy in Nigerian children with SCA. A double-blind RCT of oral L-arginine-hydrochloride (100 mg/kg TID) was conducted in children with SCA-VOC, aged 5-17 years, hospitalized at two Nigerian sites. The primary outcome measure was analgesic usage, quantified by difference in the mean Analgesic Medication Quantification Scale (MQS). Secondary outcomes included daily pain scores, time-to-crisis-resolution and length-of-hospital-stay. An intention-to-treat analysis was performed. Sixty-eight children (age 5-17 years, mean 10.6 ± 0.4 years; 56% male), were randomized to receive L-arginine (35 patients) or placebo (33 patients). The mean total MQS for the arginine group was 73.4 (95% CI, 62.4-84.3) vs 120.0 (96.7-143.3) for placebo (P < .001). The mean rate of decline in worst pain scores was faster in the arginine arm vs placebo (1.50 [1.23-1.77] vs 1.09 [0.94-1.24] point/d, P = .009). Children receiving arginine had a shorter time-to-crisis-resolution (P = .02), shorter hospital-stay (P = .002) and experienced no serious adverse event. Pain control was more rapid, total analgesic requirement was significantly reduced, and most notably, time-to-crisis-resolution and length-of-hospital-stay were shorter in children with SCA-VOC receiving arginine vs placebo. Given the established safety and low cost, oral arginine is a promising adjuvant therapy for SCA-VOC management.","journal":"American Journal of Hematology","year":2020,"id":92233,"datarank":0.5676284450877392,"base_score":3.784189633918261,"endowment":3.784189633918261,"self_citation_contribution":0.5676284450877392,"citation_network_contribution":0.0,"self_endowment_contribution":0.5676284450877392,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":43,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9554,"is_data_producer":true,"deposit_databanks":{"PACTR":["PACTR201611001864290"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":462550,"name":"Peter Cooper","orcid":null,"position":1,"is_corresponding":false},{"id":461440,"name":"Antoinette Cilliers","orcid":"0009-0005-2347-6663","position":2,"is_corresponding":false},{"id":461441,"name":"Barend Christiaan Vorster","orcid":"0000-0003-2371-288X","position":3,"is_corresponding":false},{"id":462551,"name":"Nnebe‐Agumadu Uche","orcid":null,"position":4,"is_corresponding":false},{"id":462552,"name":"Oniyangi O. Oluseyi","orcid":null,"position":5,"is_corresponding":false},{"id":462553,"name":"Victoria D. Onalo","orcid":null,"position":6,"is_corresponding":false},{"id":462554,"name":"Yunusa Zubairu","orcid":null,"position":7,"is_corresponding":false},{"id":462555,"name":"Alice U. Ayodele‐Kehinde","orcid":null,"position":8,"is_corresponding":false},{"id":462556,"name":"Oladimeji M. Damilare","orcid":null,"position":9,"is_corresponding":false},{"id":333563,"name":"Janet Figueroa","orcid":"0000-0002-7900-9336","position":10,"is_corresponding":false},{"id":333554,"name":"Claudia R. Morris","orcid":"0000-0001-6019-2858","position":11,"is_corresponding":false},{"id":461439,"name":"Richard Onalo","orcid":"0000-0001-6240-3786","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-18T22:29:54.256205Z","pmid":"33075179","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}