Morphine removal and kidney filtering in adults with sickle cell crises in intensive care

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Adults with sickle cell disease admitted to ICU for vaso-occlusive crisis or acute chest syndrome who are receiving patient-controlled morphine will have their kidney filtration measured with an injected iohexol marker and blood sampling for morphine and metabolites. The study compares measured glomerular filtration rate (GFR) to morphine pharmacokinetics to see if renal hyperfiltration accelerates morphine elimination. Patients already on baseline opioid substitution or with contraindications to iohexol are excluded. Findings aim to clarify whether standard morphine dosing under-treats pain in patients with increased GFR.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Patient ≥ 18 years old
* Known homozygous sickle cell disease SS, SC, S-beta+, or S-beta0
* Admitted in an intensive care unit
* Clinical diagnosis of vaso-occlusive crisis and/or acute chest syndrome
* Receiving PCA treatment with morphine
* Patient's consent for study participation and/or from a relative if case of patient's incapacity
* Affiliation to social protection

Exclusion Criteria:

* Patient previously included in the study during a previous stay
* Injection of iodinated contrast medium outside the scope of the study within 24 hours prior to inclusion, or scheduled within 9 hours following the scheduled time of iohexol injection
* Contraindication to iohexol: known or suspected immediate or delayed hypersensitivity, thyrotoxicosis.
* Patient undergoing morphine treatment or substitution treatment such as methadone or buprenorphine prior to hospitalization (having received morphine or a derivative regardless of the route of administration in the week prior to hospitalization).
* Chronic liver disease likely to interfere with morphine metabolism (cirrhosis )
* Any condition that contraindicates the use of morphine according to the summary of product characteristics
* Patients under legal protection
* Pregnant or breastfeeding women

Exclusion criteria :

* Need for extrarenal epuration within 24 hours of inclusion

Where it's running

• CHRU de Tours
  Tours, France, France Recruiting
• Henri-Mondor
  Créteil, France Not yet recruiting
• CH Le Mans
  Le Mans, France Not yet recruiting
• CHU de Nantes
  Nantes, France Not yet recruiting
• CHU d'Orléans
  Orléans, France Not yet recruiting
• CHU de Rennes
  Rennes, France Not yet recruiting

Study contacts

• Study coordinator: Charlotte SALMON-GANDONNIERE, MD
• Email: charlotte.salmon.gandonniere@gmail.com
• Phone: +33 2 47 47 38 55

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Low-dose ketamine for sickle cell vaso-occlusive pain in children and young adults

  This trial will test whether adding a low (sub-dissociative) dose ketamine infusion to usual IV opioid pain medicine helps children and young adults (ages 5–20) with sickle cell disease have better pain relief and remain safe during a vaso-occlusive episode.

  Recruiting Phase 2 Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center · Torrance, California · NCT07369024

• Regional anesthesia to reduce inflammation during vaso‑occlusive crises in sickle cell disease

  This project will test whether giving regional (loco‑regional) anesthesia to adults hospitalized for sickle cell vaso‑occlusive crises reduces inflammatory markers and speeds recovery compared with usual care.

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• Tocilizumab for Acute Chest Syndrome in Sickle Cell Disease

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  This study is testing if a low dose of tocilizumab can help people with sickle cell disease who have acute chest syndrome feel better during their hospital stay.

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• Cerebrovascular Reactivity Testing with HD-DOT in Sickle Cell Patients

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  Recruiting Washington University School of Medicine · St Louis, Missouri · NCT07776444

• Adapting and testing PEN-Plus in Zambian primary care

  Aiming to see if the PEN-Plus package can be adapted and used in two Zambian hospitals to better manage chronic diseases like heart disease, diabetes, hypertension, and sickle cell in primary care.

  Recruiting Centre for Infectious Disease Research in Zambia · Lusaka, Lusaka Province · NCT07753681

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.