Speaking from the British Society for Haematology (BSH) 2018 Annual Scientific Meeting, in Liverpool, UK, Bart Biemond, MD, PhD, from the Academic Medical Centre, Amsterdam, Netherlands, discusses new therapeutic approaches in sickle cell disease that are targeting red blood cell adhesion and oxygen affinity, both of which drive most of the organ failure seen in latter stages of the disease. Examples of these drugs include rivipansel, crizanlizumab and modified heparin agents that are currently in Phase II or III trials