Adherence to Iron Chelation Therapy among Adults with Thalassemia: A Systematic Review

Locke, Margaret; Reddy, Paavani S; Badawy, Sherif M.

doi:10.1080/03630269.2022.2072320

Cited by 10 publications

(6 citation statements)

References 73 publications

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“…Orally administered DFX offers an opportunity to improve outcomes for patients through improved adherence. 23,24 Previous systematic reviews have evaluated DFX by comparison with DFO in their capacity to reduce iron overload but have focused on patients with thalassemia [13][14][15][16] and so there is a need to evaluate these iron chelating agents in patients with SCA. Although limited by the number of studies included in the review, the results of this present meta-analysis showed that liver iron concentration showed no difference between DFX and DFO.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis

Qadah

2022

J Int Med Res

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Objectives To examine the efficacy of deferasirox (DFX) by comparison with deferoxamine (DFO) in managing iron overload in patients with sickle cell anaemia (SCA). Methods Online databases were systematically searched for studies published from January 2007 to July 2022 that had investigated the efficacy of DFX compared with DFO in managing iron overload in patients with SCA. Results Of the 316 articles identified, three randomized clinical trials met the inclusion criteria. Meta-analysis of liver tissue iron concentration (LIC) showed that iron overload was not significantly higher in the DFX group compared with DFO group (WMD, −1.61 mg Fe/g dw (95% CI −4.42 to 1.21). However, iron overload as measured by serum ferritin was significantly lower in DFO compared with DFX group (WMD, 278.13 µg/l (95% CI 36.69 to 519.57). Although meta-analysis was not performed on myocardial iron concentration due to incomplete data, the original report found no significant difference between DFX and DFO. Conclusion While limited by the number of studies included in this meta-analysis, overall, the results tend to show that DFX was as effective as DFO in managing iron overload in patients with SCA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis

Qadah

2022

J Int Med Res

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“…Red blood cell transfusions correct the anemia, and iron chelation therapy helps offset the increased iron accumulation or overload from the transfusions, though adherence remains a challenge among children and adults with thalassemia. 3,4 Another therapy for TDT is luspatercept, an activin receptor ligand trap. 5 Luspatercept is a recombinant fusion protein that promotes late-stage erythropoiesis.…”

Section: Management Of Thalassemiamentioning

confidence: 99%

“…A standard approach used in both TDT and NTDT includes regular or occasional red blood cell transfusions, respectively, with an iron chelation therapy. Red blood cell transfusions correct the anemia, and iron chelation therapy helps offset the increased iron accumulation or overload from the transfusions, though adherence remains a challenge among children and adults with thalassemia 3,4 . Another therapy for TDT is luspatercept, an activin receptor ligand trap 5 .…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life with standard and curative therapies in thalassemia: A narrative literature review

Shah,

Badawy

2024

Annals of the New York Academy of Sciences

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Health‐related quality of life (HRQOL) is a patient‐reported outcome that assesses the impact of a disease or illness on different domains of a patient's life. Different general and disease‐specific measures can be used to evaluate HRQOL. This article aimed to summarize the evidence for HRQOL among patients with transfusion‐dependent (TDT) and non‐transfusion‐dependent thalassemia (NTDT). We included HRQOL data related to standard therapy with blood transfusions, iron chelation, and/or luspatercept in TDT and NTDT, as well as curative therapies for TDT, including hematopoietic stem cell transplant (HSCT) and gene therapy. Patients with thalassemia had worse HRQOL scores compared to the general population, and chronic pain was seen to increase in frequency and severity over time with age. NTDT patients reported worse physical health and functioning, mental health, general health, and vitality than TDT patients. However, TDT patients reported worse pain, change in health, and social support than NTDT. Most therapies improved overall HRQOL among thalassemia patients. Deferasirox, an oral iron chelator, was associated with more HRQOL benefits compared to deferoxamine, an intravenous iron chelator. Luspatercept showed clinically meaningful improvement in physical functioning among TDT and NTDT. Furthermore, HSCT and gene therapy were associated with better physical, emotional, and mental domains scores.

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“…But studies on long-term survival, cardiac outcomes, complications, and safety are lacking. [10][11][12] While generics can substantially lower costs, realized savings depend on utilization rates, pricing policies, The use of generic medications in thalassemia and hemoglobinopathies: challenges, benefits, and economic impact availability, and other health system factors. There is a need for expanded comparative effectiveness research directly in thalassemia populations and standardized bioequivalence criteria tailored to these patients.…”

Section: Evidence On Generic Medications In Thalassemiamentioning

confidence: 99%

The use of generic medications in thalassemia and hemoglobinopathies: challenges, benefits, and economic impact

Delicou

2023

HTIJ

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Thalassemia and hemoglobinopathies necessitate lifelong disease management, leading to significant treatment costs. Generic medications offer potential cost savings, but concerns persist regarding their comparative effectiveness and safety compared to brand-name drugs. This comprehensive review evaluates the evidence concerning the utilization of generics for transfusion-dependent thalassemia and hemoglobinopathies. Quality-assured generics can offer substantial cost savings for both health systems and patients, contingent upon ensuring bioequivalence, efficacy, pharmacovigilance, and addressing stakeholder concerns.

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Adherence to Iron Chelation Therapy among Adults with Thalassemia: A Systematic Review

Cited by 10 publications

References 73 publications

Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis

Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis

Health‐related quality of life with standard and curative therapies in thalassemia: A narrative literature review

The use of generic medications in thalassemia and hemoglobinopathies: challenges, benefits, and economic impact

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