{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:51:01Z","timestamp":1790884261651,"version":"4.1.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100002738","name":"Assistance Publique\u2013H\u00f4pitaux de Paris","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008271","name":"LEO Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008271","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002738","name":"Assistance Publique\u2013H\u00f4pitaux de Paris","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002738","name":"LEO Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Patients with sickle cell disease hospitalized for acute chest syndrome (ACS) are at high risk of in situ pulmonary microthrombosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated whether therapeutic anticoagulation could shorten ACS duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>TASC (Therapeutic Anticoagulation for Acute Chest Syndrome in Sickle Cell Disease) is a randomized, controlled, double-blind trial conducted in 12 French hospitals (December 2016\u2013April 2021) in adult patients with ACS with no initial thrombosis on chest computed tomography with pulmonary angiogram. We randomized 172 patients (1:1) to receive either prophylactic or therapeutic doses of low-molecular-weight tinzaparin for 7 days. The primary efficacy outcome was time to ACS resolution. The primary safety outcome was major bleeding. Main secondary outcomes included parenteral opioid consumption, transfusion, mortality at hospital discharge, and hospital readmissions at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>The primary efficacy outcome, time to ACS resolution, analyzed using a Cox model, was shorter with therapeutic anticoagulation than with prophylactic doses (hazard ratio, 0.71; 95% confidence interval, 0.51 to 0.99; P\u2009=\u20090.044). As a supplemental estimate, the restricted mean time to ACS resolution (over a 15-d horizon or discharge) was shorter with therapeutic doses (4.8\u2009\u00b1\u20090.4 vs. 6.1\u2009\u00b1\u20090.5 d). The primary safety outcome (major bleeding) did not occur in either group. The cumulative dose of parenteral opioids was lower with therapeutic anticoagulation: median [interquartile range] of 124 [80 to 272] vs. 219 [65 to 378] mg morphine equivalent; difference, \u221296; 95% confidence interval, \u2212202 to \u221246; P\u2009=\u20090.02. Other short- and long-term secondary outcomes were similar between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adult patients with ACS, a therapeutic anticoagulation shortened ACS duration and reduced opioid consumption compared with prophylactic doses, without increasing bleeding risk.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.clinicaltrials.gov (NCT02580773).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202409-1727oc","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T15:28:31Z","timestamp":1744298911000},"page":"832-841","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of Prophylactic and Therapeutic Doses of Anticoagulation for Acute Chest Syndrome in Sickle Cell Disease: The TASC Double-Blind Controlled Randomized Clinical Trial"],"prefix":"10.1093","volume":"211","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-5577","authenticated-orcid":false,"given":"Armand","family":"Mekontso Dessap","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Intensive R\u00e9animation"},{"name":"Groupe de Recherche Clinique CARMAS, Institut Mondor de Recherche Biom\u00e9dicale, Universit\u00e9 Paris Est Cr\u00e9teil, Cr\u00e9teil, France"},{"name":"INSERM U955, Universit\u00e9 Paris Est Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoosha","family":"Habibi","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Maladies G\u00e9n\u00e9tiques du Globule Rouge, Centre de r\u00e9f\u00e9rence Syndromes Dr\u00e9panocytaires Majeurs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Beno\u00eet","family":"Arlet","sequence":"additional","affiliation":[{"name":"Department of Internal 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