{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:31:37Z","timestamp":1791945097931,"version":"4.3.4"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,10,13]]},"abstract":"\n Importance<\/jats:title>\n Acute pain episodes are the leading cause of emergency department visits and hospitalizations for patients with sickle cell disease (SCD), yet US Food and Drug Administration\u2013approved drugs for acute pain episodes are lacking. During acute pain episodes, patients develop acute arginine deficiency associated with longer time to crisis resolution and greater total parenteral opioid use. Multiple single-center, phase 2 randomized clinical trials have shown that arginine is safe, is opioid sparing, improves cardiopulmonary function, and reduces length of hospital stay.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the efficacy and safety of intravenous arginine for SCD acute pain episodes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Prospective, phase 3, double-blind randomized clinical trial conducted between June 21, 2021, and June 13, 2024, in 10 US children\u2019s hospitals enrolling patients aged 3 to 21 years presenting to the emergency department with SCD acute pain episodes requiring parenteral opioids.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Patients were randomized to receive intravenous arginine (200 mg\/kg followed by 100 mg\/kg every 8 hours until discharge; n\u2009=\u2009129) or saline placebo (n\u2009=\u2009142).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was time to crisis resolution, defined as hours from initial study drug delivery to last intravenous opioid dose. Secondary outcomes included total parenteral opioid use (intravenous morphine equivalents in milligrams per kilogram from first study drug dose to last intravenous opioid dose), pain scores, and patient-reported outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 274 randomized participants, 271 received study drug; the mean age was 14.3 years (SD, 4.3 years), 51% were male, and 92% were Black. The trial was halted early for futility, as time to crisis resolution was similar in those receiving arginine vs placebo (median, 60.8 hours [IQR, 34.8-109.0 hours] vs 65.8 hours [IQR, 31.1-111.1 hours], respectively; absolute difference, 7.2 hours; 95% CI, \u221221.6 to 35.9 hours). No significant differences were seen in total parenteral opioid use, pain scores, patient-reported outcomes, or safety events.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Arginine therapy did not shorten time to crisis resolution compared with placebo among children and young adults with SCD acute pain episodes.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04839354<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2026.13310","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:30:41Z","timestamp":1787153441000},"page":"1228","source":"Crossref","is-referenced-by-count":1,"title":["Arginine Therapy for Sickle Cell Disease Acute Pain Episodes"],"prefix":"10.1001","volume":"336","author":[{"given":"Claudia R.","family":"Morris","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunia","family":"Hatabah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan","family":"Korman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahd A.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladstone","family":"Airewele","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital and Baylor College of Medicine, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolanle","family":"Akinsola","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Alzraikat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitya","family":"Bakshi","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Brousseau","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nemours Children\u2019s Health Delaware and the Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Brown","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Charles","family":"Casper","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd P.","family":"Chang","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrie E.","family":"Chumpitazi","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Cohen","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keli D.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin and Children\u2019s Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Covelo","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea T.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital and Baylor College of Medicine, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Denton","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Ellison","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Fields","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Jensen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Leibovich","sequence":"additional","affiliation":[{"name":"University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris A.","family":"Rees","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Remiker","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin and Children\u2019s Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Singh","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital and Baylor College of Medicine, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Thompson","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliott","family":"Vichinsky","sequence":"additional","affiliation":[{"name":"Center for Maternal-Fetal Precision Medicine, University of California, San Francisco"},{"name":"Department of Pediatrics and UCSF-Benioff Children\u2019s Hospital\u2013Oakland, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Villella","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagar","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Wynn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlton","family":"Dampier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Pediatric Emergency Care Applied Research Network (PECARN)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"joi260083r1","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1002\/ajh.26837","article-title":"Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: a multicenter pediatric emergency medicine perspective.","volume":"98","author":"Rees","year":"2023","journal-title":"Am J Hematol"},{"issue":"10","key":"joi260083r2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30553","article-title":"Return visit rates after an emergency department discharge for children with sickle cell pain episodes.","volume":"70","author":"Coleman","year":"2023","journal-title":"Pediatr Blood Cancer"},{"issue":"13","key":"joi260083r3","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1001\/jama.2010.378","article-title":"Acute care utilization and rehospitalizations for sickle cell disease.","volume":"303","author":"Brousseau","year":"2010","journal-title":"JAMA"},{"issue":"7","key":"joi260083r4","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1002\/ajh.27692","article-title":"Arginine therapy for pain in sickle cell disease: a phase-2 randomized, placebo-controlled trial.","volume":"100","author":"Morris","year":"2025","journal-title":"Am J Hematol"},{"issue":"10","key":"joi260083r5","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1182\/bloodadvances.2023011730","article-title":"Successes and pitfalls in orphan drug development for sickle cell disease.","volume":"8","author":"Costa","year":"2024","journal-title":"Blood Adv"},{"issue":"10","key":"joi260083r6","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1001\/jama.2014.10517","article-title":"Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members.","volume":"312","author":"Yawn","year":"2014","journal-title":"JAMA"},{"issue":"1","key":"joi260083r7","doi-asserted-by":"publisher","first-page":"30S","DOI":"10.1177\/0884533617691250","article-title":"Acquired amino acid deficiencies: a focus on arginine and glutamine.","volume":"32","author":"Morris","year":"2017","journal-title":"Nutr Clin Pract"},{"issue":"6","key":"joi260083r8","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1097\/00043426-200011000-00009","article-title":"Patterns of arginine and nitric oxide in patients with sickle cell disease with vaso-occlusive crisis and acute chest syndrome.","volume":"22","author":"Morris","year":"2000","journal-title":"J Pediatr Hematol Oncol"},{"issue":"12","key":"joi260083r9","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1038\/nm1202-799","article-title":"Cell-free hemoglobin limits nitric oxide bioavailability in sickle-cell disease.","volume":"8","author":"Reiter","year":"2002","journal-title":"Nat Med"},{"issue":"1","key":"joi260083r10","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1001\/jama.294.1.81","article-title":"Dysregulated arginine metabolism, hemolysis-associated pulmonary hypertension, and mortality in sickle cell disease.","volume":"294","author":"Morris","year":"2005","journal-title":"JAMA"},{"issue":"9","key":"joi260083r11","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3324\/haematol.2013.086637","article-title":"A randomized, placebo-controlled trial of arginine therapy for the treatment of children with sickle cell disease hospitalized with vaso-occlusive pain episodes.","volume":"98","author":"Morris","year":"2013","journal-title":"Haematologica"},{"issue":"1","key":"joi260083r12","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1002\/ajh.26028","article-title":"Randomized control trial of oral arginine therapy for children with sickle cell anemia hospitalized for pain in Nigeria.","volume":"96","author":"Onalo","year":"2021","journal-title":"Am J Hematol"},{"issue":"6-7","key":"joi260083r13","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1080\/08880018.2025.2549365","article-title":"The efficacy of oral L-arginine therapy for the treatment of vaso-occlusive pain episodes in children with sickle cell disease.","volume":"42","author":"Abd Elglil","year":"2025","journal-title":"Pediatr Hematol Oncol"},{"issue":"5","key":"joi260083r14","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s40272-025-00701-w","article-title":"Clinical study to evaluate the possible efficacy and safety of L-arginine in children with sickle cell disease and increased tricuspid regurgitant jet velocity: a randomized controlled trial.","volume":"27","author":"Gomaa","year":"2025","journal-title":"Paediatr Drugs"},{"issue":"1","key":"joi260083r15","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1164\/rccm.202108-1930OC","article-title":"Arginine therapy and cardiopulmonary hemodynamics in hospitalized children with sickle cell anemia: a prospective, double-blinded, randomized placebo-controlled clinical trial.","volume":"206","author":"Onalo","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"joi260083r16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1164\/rccm.200208-967OC","article-title":"Arginine therapy: a new treatment for pulmonary hypertension in sickle cell disease?","volume":"168","author":"Morris","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"joi260083r17","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1186\/s13063-023-07538-z","article-title":"Sickle Cell Disease Treatment With Arginine Therapy (STArT): study protocol for a phase 3 randomized controlled trial.","volume":"24","author":"Rees","year":"2023","journal-title":"Trials"},{"issue":"12","key":"joi260083r18","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1182\/blood.2019003672","article-title":"Impact of arginine therapy on mitochondrial function in children with sickle cell disease during vaso-occlusive pain.","volume":"136","author":"Morris","year":"2020","journal-title":"Blood"},{"issue":"12","key":"joi260083r19","doi-asserted-by":"publisher","first-page":"3267","DOI":"10.1182\/bloodadvances.2023012209","article-title":"Impact of arginine therapy on kyotorphin in children with sickle cell disease and vaso-occlusive pain.","volume":"8","author":"Korman","year":"2024","journal-title":"Blood Adv"},{"issue":"1","key":"joi260083r20","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1001\/jama.2007.64","article-title":"Trends in opioid prescribing by race\/ethnicity for patients seeking care in US emergency departments.","volume":"299","author":"Pletcher","year":"2008","journal-title":"JAMA"},{"issue":"5","key":"joi260083r21","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.jpain.2016.12.016","article-title":"AAPT diagnostic criteria for chronic sickle cell disease pain.","volume":"18","author":"Dampier","year":"2017","journal-title":"J Pain"},{"issue":"7","key":"joi260083r22","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1093\/pch\/pxab011","article-title":"An assessment of the psychometric properties of the Stoplight Pain Scale in a Canadian paediatric emergency department.","volume":"26","author":"Ali","year":"2021","journal-title":"Paediatr Child Health"},{"issue":"17","key":"joi260083r23","doi-asserted-by":"publisher","first-page":"5103","DOI":"10.1182\/bloodadvances.2021006794","article-title":"Patient-reported outcomes in children with sickle cell disease at presentation for an acute pain episode.","volume":"7","author":"Bakshi","year":"2023","journal-title":"Blood Adv"},{"issue":"14","key":"joi260083r24","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1182\/blood-2015-05-647107","article-title":"A multicenter randomized controlled trial of intravenous magnesium for sickle cell pain crisis in children.","volume":"126","author":"Brousseau","year":"2015","journal-title":"Blood"},{"issue":"9","key":"joi260083r25","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1001\/jama.2011.235","article-title":"Nitric oxide for inhalation in the acute treatment of sickle cell pain crisis: a randomized controlled trial.","volume":"305","author":"Gladwin","year":"2011","journal-title":"JAMA"},{"issue":"15","key":"joi260083r26","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1001\/jama.2021.3414","article-title":"Effect of poloxamer 188 vs placebo on painful vaso-occlusive episodes in children and adults with sickle cell disease: a randomized clinical trial.","volume":"325","author":"Casella","year":"2021","journal-title":"JAMA"},{"issue":"2","key":"joi260083r27","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1182\/blood.2022015797","article-title":"A randomized clinical trial of the efficacy and safety of rivipansel for sickle cell vaso-occlusive crisis.","volume":"141","author":"Dampier","year":"2023","journal-title":"Blood"},{"issue":"5","key":"joi260083r28","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1111\/j.1365-2141.2010.08395.x","article-title":"A randomized phase II trial of arginine butyrate with standard local therapy in refractory sickle cell leg ulcers.","volume":"151","author":"McMahon","year":"2010","journal-title":"Br J Haematol"},{"issue":"4","key":"joi260083r29","doi-asserted-by":"publisher","first-page":"e147","DOI":"10.1016\/S2352-3026(18)30020-6","article-title":"Ready-to-use food supplement, with or without arginine and citrulline, with daily chloroquine in Tanzanian children with sickle-cell disease: a double-blind, random order crossover trial.","volume":"5","author":"Cox","year":"2018","journal-title":"Lancet Haematol"},{"issue":"4","key":"joi260083r30","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1111\/j.1600-0609.2009.01210.x","article-title":"Hematologic, biochemical, and cardiopulmonary effects of L-arginine supplementation or phosphodiesterase 5 inhibition in patients with sickle cell disease who are on hydroxyurea therapy.","volume":"82","author":"Little","year":"2009","journal-title":"Eur J Haematol"},{"issue":"1","key":"joi260083r31","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1002\/ajh.70129","article-title":"Hospital variations in time-to-crisis-resolution among children and adolescents with sickle cell disease.","volume":"101","author":"Rees","year":"2026","journal-title":"Am J Hematol"},{"issue":"2","key":"joi260083r32","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1002\/pbc.20180","article-title":"Variation in hospitalizations and hospital length of stay in children with vaso-occlusive crises in sickle cell disease.","volume":"44","author":"Panepinto","year":"2005","journal-title":"Pediatr Blood Cancer"},{"issue":"14","key":"joi260083r33","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1182\/blood-2015-08-662502","article-title":"MAGiC: VOC remains but kids with SCA appear.","volume":"126","author":"Estepp","year":"2015","journal-title":"Blood"},{"issue":"2","key":"joi260083r34","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1177\/1740774513475850","article-title":"IMPROVE trial: a randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies.","volume":"10","author":"Dampier","year":"2013","journal-title":"Clin Trials"},{"issue":"11","key":"joi260083r35","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1080\/17474086.2020.1830370","article-title":"What is the future of patient-reported outcomes in sickle-cell disease?","volume":"13","author":"Singh","year":"2020","journal-title":"Expert Rev Hematol"},{"issue":"1","key":"joi260083r36","doi-asserted-by":"publisher","first-page":"E21","DOI":"10.1002\/ajh.26396","article-title":"Safety of intravenous arginine therapy in children with sickle cell disease hospitalized for vaso-occlusive pain: a randomized placebo-controlled trial in progress.","volume":"97","author":"Reyes","year":"2022","journal-title":"Am J Hematol"},{"issue":"24","key":"joi260083r37","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.1182\/blood.2023021220","article-title":"The challenge of clinical end points in sickle cell disease.","volume":"142","author":"Ataga","year":"2023","journal-title":"Blood"},{"key":"joi260083r38","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ajem.2024.10.028","article-title":"Trends and hospital practice variation for analgesia for children with sickle cell disease with vaso-occlusive pain episodes: an 11-year analysis.","volume":"86","author":"Eltorki","year":"2024","journal-title":"Am J Emerg Med"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2853065\/jama_morris_2026_oi_260083_1790887535.93088.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:00:35Z","timestamp":1791903635000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2853065"}},"subtitle":["The STArT Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":38,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,10,13]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2026.13310","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,13]]}}}