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Safety and efficacy of L-Glutamine in reducing the frequency of acute complications among patients with sickle cell disease: A randomized controlled study.

  • 2024-07-19
  • Annals of hematology 103(9)
    • Fatma Soliman Elsayed Ebeid
    • Nihal Hussien Aly
    • Naglaa Mohammed Shaheen
    • Samah Mohammed Ahmed Abdellatif
    • Ahmed Ashraf Mahmoud Okba
    • Nada Ayman Gad
    • Sara Mostafa Makkeyah

Study Design

Type
Randomized Controlled Trial (RCT)
Population
sixty SCD patients, aged 9.2 ± 3.7 years, who had at least two VOCs during the last 12 months and on a stable dose of hydroxyurea
Methods
interventional randomized controlled trial, 1:1 ratio to receive glutamine (0.3 gm/kg/dose/12h) orally for 24 weeks or the standard of care (SOC)
Blinding
Open-label
Duration
24 weeks
Funding
Unclear
To evaluate the safety and efficacy of L-glutamine in reducing vaso-occlusive crisis (VOC) and improving cerebral arterial blood flow in children with sickle cell disease (SCD). This is an interventional randomized controlled trial that recruited sixty SCD patients, aged 9.2 ± 3.7 years, who had at least two VOCs during the last 12 months and on a stable dose of hydroxyurea. They were randomly assigned in a 1:1 ratio to receive glutamine (0.3 gm/kg/dose/12h) orally for 24 weeks or the standard of care (SOC). All patients had VOCs in the last year > 3, those on glutamine had a higher number of VOCs and hospitalization for VOC in the last year. There was a decreasing trend in the number, severity, and hospitalization of VOC and a significantly lower cumulative number of VOCs and hospitalizations in the glutamine group than in SOC (p = 0.008, p < 0.001 respectively). Time-averaged mean maximum velocity for the glutamine group had a marginal increase in both middle cerebral arteries, all values remained normal within a normal range, and in both internal carotid arteries, values increased from abnormally low to normal ranges at week 24. Glutamine reduced the number of VOCs and severity and may have a potentially favorable impact on the cerebral arterial flow velocities.

Research Insights

  • L-Glutamine→Improved Cerebral Blood Flow Velocity

    Time-averaged mean maximum velocity for the glutamine group had a marginal increase in both middle cerebral arteries ... and in both internal carotid arteries, values increased from abnormally low to normal ranges at week 24

    Effect
    Beneficial
    Effect size
    Small
    Dose
    0.3 gm/kg/dose/12h
  • L-Glutamine→Reduced Hospitalization for Vaso-Occlusive Crisis

    a significantly lower cumulative number of ... hospitalizations in the glutamine group than in SOC (p=0.008, p<0.001 respectively)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    0.3 gm/kg/dose/12h
  • L-Glutamine→Reduced Vaso-Occlusive Crisis Frequency

    a significantly lower cumulative number of VOCs ... in the glutamine group than in SOC (p=0.008, p<0.001 respectively)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    0.3 gm/kg/dose/12h
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