Suzetrigine for Vaso-Occlusive Pain in Sickle Cell Disease: A Three-Patient Case Series.

Background: Sickle cell disease (SCD) is characterized by recurrent vaso-occlusive crises and chronic pain, often requiring multimodal analgesia that frequently includes opioids. Given the risks associated with long-term opioid therapy, there is a growing need for effective non-opioid alternatives. Suzetrigine, a selective NaV1.8 sodium channel inhibitor, represents a novel analgesic approach targeting peripheral nociceptive signaling. Methods: We present a case series of three patients with sickle cell-related pain treated with suzetrigine as part of a multimodal pain management strategy. The cohort included one patient with sickle cell trait (HbAS), one with hemoglobin SC disease, and one with hemoglobin SS disease. Clinical outcomes, including pain control, healthcare utilization, and medication use, were evaluated. Results: Two of three patients reported subjective improvement in pain control with suzetrigine, including reduced reliance on opioid medications and no emergency department visits or hospitalizations during the observation period. Both patients were on minimal opioid therapy. In contrast, the third patient, who was maintained on chronic opioid therapy, did not experience improvement and required hospitalization for pain management. No adverse effects related to suzetrigine were observed in any patient. Conclusion: Suzetrigine may be a non-opioid adjunct for managing sickle cell-related pain, particularly in opioid-naïve or opioid-intolerant patients. However, its efficacy may be limited in opioid-tolerant individuals. Larger studies are needed to better define its role in the management of vaso-occlusive pain and chronic pain in SCD.