Bibliographic information
GuidelineWHO consolidated guidelines for the management of common childhood illness: management of sickle-cell disease in children and adolescents
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
In children and adolescents (aged 0–19 years) with sickle-cell disease (SCD), the use of non-steroidal anti-inflammatory drugs (NSAIDs) in combination with opioids is suggested for the management of moderate to severe acute pain, rather than opioids alone.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
- The GDG acknowledged that in real-world settings, this recommendation may be implemented through a stepwise approach, initiating treatment with NSAIDs and escalating to combination therapy with opioids if pain is not adequately controlled.
- The decision to use NSAIDs in combination with opioids should be guided by the patient‘s baseline pain severity, individual preferences and a clear explanation of the potential benefits and harms of both NSAID and opioid therapies.
- Shared decision-making between health care providers, patients and caregivers is essential to ensure safe, effective and acceptable pain management.