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CME: Strategies to prevent complications of sickle cell disease

Activity Description / Statement of Need:

In this online, self-learning activity:

Sickle cell disease (SCD) is the most common monogenic blood disorder, affecting millions of people worldwide and approximately 100,000 Americans. Although it may be found in various areas of the world, SCD predominantly affects individuals of African or Hispanic heritage. It is caused by the inheritance of b-globin alleles that code for hemoglobin S, resulting in an amino acid substitution in hemoglobin’s b chain and clinical disease. Patients with SCD have impaired circulation, and lysis of the erythrocytes contributes to a chronic inflammatory response, causing severe pain and less efficient oxygen delivery. The hallmark clinical features of SCD are hemolytic anemia and painful vaso-occlusive crises (VOCs), which may lead to emergency department visits, hospitalization, and potentially fatal complications such as acute chest syndrome, stroke, or pneumonia.

Target Audience:

The following HCPs: hematologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who specialize in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with SCD.

Commercial Support Disclosure: This program is supported by educational grants from Agios and Vertex.

This activity is free of charge.

Release Date: February 15, 2023 -- Expiration Date: February 15, 2025

Faculty: Fuad El Rassi, MD


Faculty Introduction, Disclosures

VOCs and SCD Complications 

  • VOCs
    • Pathophysiology
    • Pain
    • Hospitalization and ED use burdens
  • Complications by organ system
    • Neurologic (stroke)
    • Cardiac (LV dysfunction, MI)
    • Ocular (vision changes, retinopathy)
    • Pulmonary (PH, chronic pulmonary diseases)
    • Splenic sequestration
    • Renal (nephropathy, ESKD)
    • Bone (pain, osteomyelitis)
    • Cutaneous (ulcers)
    • Endocrine (delayed growth, adrenal dysfunction)
  • Burden of disease
    • Implications for patients and caregivers

SCD Management Throughout the Patient Journey

  • Management at vulnerable time points in the treatment journey
      • Transitional care vulnerabilities
        • Pediatric to adult
        • Referral to transplant center
    • Improving care
      • Patient education
      • Cross-discipline communication
      • Transition plans
  • Monitoring and mitigations strategies for complications
    • Recommended monitoring types and intervals
    • Reducing the risk of complications
  • Approved treatments: indications, efficacy, safety
    • Hydroxyurea
    • Voxelotor
    • L-glutamine
    • Crizanlizumab
  • Gene therapy: An emerging option
    • Options under investigation
    • Early results
    • Implications for future treatment
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Evaluate the burden of vaso-occlusive crises and potential short- and long-term complications, including implications for patients and caregivers.
  • Identify patients who are at risk for developing end-organ damage from severe SCD and develop management plans to mitigate these risks.
  • Review best practices for transitioning patients to new management teams, including the transition from pediatric to adult and from referral center to transplant center care.
  • Apply strategies to manage and prevent vaso-occlusive crises and their complications.
  • Describe novel and emerging treatment options for patients with SCD, including the use of monoclonal antibodies, small molecules, and gene therapy.


ACCME Activity #202382103

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM and ABP.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 0.75 contact hours (0.075 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-007-H01-P. This is an Knowledge (K)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosure of Faculty: Fuad El Rassi, MD, Associate Professor, Emory University School of Medicine, has received financial compensation for research and consulting work from Novartis and Forma Therapeutics.


Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL NOT discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Vertex and Agios.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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Pyruvate kinase deficiency (PKD): zeroing in on gaps in identification and treatment