{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:05:30Z","timestamp":1790060730785,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with sickle cell disease (SCD) experience painful vaso\u2010occlusive episodes that increase with age; a subset develops chronic pain (CP). CP is usually managed with acute pain management guidelines despite evidence of ineffectiveness. Buprenorphine (BUP), a partial opioid agonist, is a potent analgesic with less euphoric effect and a respiratory \u201cceiling effect.\u201d BUP therefore provides an alternative \u201charm reduction\u201d approach for CP management in pediatric SCD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single urban center retrospective study assessed the feasibility of inpatient transition to BUP\u2010containing analgesics in adolescents with SCD and CP. Patients aged 12\u201320\u00a0years who transitioned from full opioid agonists (FOA) to BUP between December 2020 and September 2022 were included. Acute care utilization, hospital length of stay, and FOA use in both inpatient and outpatient settings were compared pre\u2010 and post\u2010BUP induction for up to a year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen adolescents with SCD underwent inpatient BUP induction and maintenance therapy. Inpatient transition using a micro\u2010induction approach was feasible and well tolerated in this population. There were low rates of adverse events, such as opioid withdrawal signs. Maintenance on BUP products was sustainable over the 1\u2010year post\u2010induction period. Three patients (21%) discontinued BUP during maintenance therapy. There was a significant reduction (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) in acute care utilization, length of stay, and FOA use (both inpatient and outpatient).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Inpatient micro\u2010induction to BUP from FOA in adolescent SCD patients with CP is feasible with minimal signs of opioid withdrawal. This study suggests decreased acute care utilization with BUP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31731","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:03:36Z","timestamp":1748059416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Treatment Experience Using a Micro\u2010Induction Buprenorphine Protocol for Chronic Pain in Pediatric Sickle Cell Disease"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-3304","authenticated-orcid":false,"given":"Ashwin","family":"Patel","sequence":"first","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kalmus","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7738-2620","authenticated-orcid":false,"given":"Carlton","family":"Dampier","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifeyinwa","family":"Osunkwo","sequence":"additional","affiliation":[{"name":"Novo Nordisk Rare Disease  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2671-101X","authenticated-orcid":false,"given":"Tamara","family":"New","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"},{"name":"Johns Hopkins All Children's Hospital  St Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Gee","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8694-3496","authenticated-orcid":false,"given":"Elna","family":"Saah","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10233"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.10"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathmechdis-012418-012838"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001851"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.12.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.12.016"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx214"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13430"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2020000143"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000587"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2017.1.406"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2019.04.029"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000537"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/36780"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25401"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-019-00143-6"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S231948"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael051"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S305146"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002718"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000388"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-018-0953-z"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26699"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.04.007"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.09.014"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27407"},{"issue":"4","key":"e_1_2_7_28_1","first-page":"305","article-title":"Microinduction of Buprenorphine\/Naloxone: A Review of the Literature","volume":"30","author":"Ahmed S.","year":"2021","journal-title":"American Academy of Psychiatrists in Alcoholism and Addictions"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000001138"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-021-03068-2"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000001707"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/08971900231182772"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/fmch\u20102021\u2010001277"},{"key":"e_1_2_7_34_1","unstructured":"Centers for Medicare & Medicaid Services \u201cOpioid Oral Morphine Milligram Equivalent (MME) Conversion Factors Table for Prescription Drug Coverage \u201dCenters for Medicare & Medicaid Services 2020."},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.21980\/J8RD29"},{"key":"e_1_2_7_36_1","unstructured":"Medscape \u201cMethadone \u201dMedscape updated October2024 https:\/\/reference.medscape.com\/drug\/methadose\u2010dolophine\u2010methadone\u2010343317#91."},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep10927"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T12:44:55Z","timestamp":1754916295000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":36,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/pbc.31731"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31731","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,24]]},"assertion":[{"value":"2025-05-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31731"}}