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The Role of VBP-15 a Dissociative Steroid on the Sickle Cell Disease Pain
- Luis Almeida MD, PhD
- Alfia Khaibullina PhD
- Sayuri Kamimura, MS
- Li Wang, MD, PhD
- Julia Finkel, MD
- Zenaide Quezado, MD
While the role of ongoing inflammation during vaso-oclusive crisis and pain is recognized, effective therapeutic interventions are lacking. Glucocorticoids, with their anti-inflammatory properties, in small clinical trials have been shown to reduce the duration of analgesic therapy in children with pain crisis and in sickle cell disease patients admitted with acute chest syndrome, a course of dexamethasone decreased hospitalization time. However, clinicians hesitate to prescribe steroids to treat steroid-responsive conditions in SCD patients because its use is associated with complications that include increased risk of hospital readmission, rebound pain, strokes, avascular necrosis, and acute chest syndrome. Further, some steroid-responsive conditions such as asthma have a high incidence in SCD, however, because of known side effects, clinicians hesitate to use disease-altering therapy such as steroids in SCD patients. In turn, SCD patients who have steroid-responsive conditions may receive less than ideal treatment. VBP15 is a first-in-man dissociative steroid that has optimized sub-activities of more traditional glucocorticoids, with increased efficacy and reduced side effects. VBP15 retains NFkB inhibition (transrepression), increases membrane stabilization properties, and loses GRE-mediated transactivation activities associated with side effect profiles of clinically used steroids.
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