Combination of deferasirox and deferoxamine in clinical practice: An alternative scheme of chelation in thalassemia major patients

Cassinerio, Elena; Orofino, Nicola; Roghi, Alberto; Duca, Lorena; Poggiali, Erika; Fraquelli, Mirella; Zanaboni, Laura; Cappellini, Maria Domenica

doi:10.1016/j.bcmd.2014.04.006

Cited by 44 publications

(41 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although HYPERION was noncomparative and unblinded in nature, these results in a large patient population with severe total body iron burden expand on smaller pilot studies with DFX-DFO 18,19,21 and provide insights into the combination treatment modality followed by less intensive monotherapy for a duration longer than 1 year. Tanner et al have also reported on combined chelation therapy in patients with both mild-to-moderate 17 and severe 15 myocardial siderosis but using deferiprone and DFO.…”

mentioning

confidence: 99%

“…[14][15][16][17] Small studies using combination DFX-DFO therapy have shown a rapid reduction in systemic and myocardial iron with no increase in toxicity. [18][19][20][21] However, few patients assessed with any combination therapy to date have had severe total body iron burden as reflected by significant elevations in both liver and myocardial iron.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of deferasirox-deferoxamine on myocardial and liver iron in patients with severe transfusional iron overload

Aydınok

Kattamis

Cappellini

et al. 2015

Blood

View full text Add to dashboard Cite

Key Points• DFX-DFO combination followed by DFX monotherapy led to a meaningful decrease in myocardial and liver iron in severe siderosis patients.• Substantial liver iron reduction may be helpful in patients needing rapid control of liver iron (eg, pretransplant or planned pregnancy). Geometric mean mT2* ratios (Gmean month12/24 /Gmean baseline ) were 1.09 and 1.30, respectively, increasing from 7.2 ms at baseline (n 5 60) to 7.7 ms at 12 (n 5 52) and 9.5 ms at 24 months (n 5 36). Patients (17 of 60; 28.3%) achieved mT2* ‡10 ms and ‡10% increase from baseline at month 24; 15 switched to monotherapy during the study based on favorable mT2*. LIC decreased substantially from a baseline of 33.4 to 12.8 mg Fe/g dry weight at month 24 (252%). LVEF remained stable with no new arrhythmias/cardiac failure. Five patients discontinued with mT2* <5 ms and 1 died (suspected central nervous system infection). Safety was consistent with established monotherapies. Results show clinically meaningful improvements in mT2* in about one-third of patients remaining on treatment at month 24, alongside rapid decreases in LIC in this heavily iron-overloaded, difficult-to-treat population. Combination therapy may be useful when rapid LIC reduction is required, regardless of myocardial iron overload. This trial was registered at www.clinicaltrials.gov as #NCT01254227. (Blood. 2015;125(25):3868-3877)

show abstract

mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of deferasirox-deferoxamine on myocardial and liver iron in patients with severe transfusional iron overload

Aydınok

Kattamis

Cappellini

et al. 2015

Blood

View full text Add to dashboard Cite

show abstract

“…it is also observed in the study of Cassinero et al, that one-year regime of defroxamine and osveral combination decreased significantly the serum iron level form 11.44mg/g dw to 6.54mg/g dw and serum ferritin level from 2254ng/ml to 1346ng/ml. 24 It was observed in Jasim et al, study that in patients receiving desferal and osveral simultaneously, the ferritin rate in one year decreased about 23.3% and in patients receiving osveral alone this rate decreased about 18%. 25 Arandi et al, observed that patients receiving deferoxamin + osveral in one year, the level of ferritin serum decreased from 4031 to 2416 meaningfully (p=0.001).…”

Section: Discussionmentioning

confidence: 95%

“…27 Cassinerio et al, indicated that no considerable hepatic and kidney side-effects were seen in desferal and osveral receivers. 24 Jasim et al, observed that there is no meaningful difference in operational tests of kidneyhepatic, the number of plackets, sight, hearing, etc. between desferal and osveral simultaneously and osveral receiving alone.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Osveral efficacy in reducing ferritin levels in patients with thalassemia major

Fathi

Vafaie

Amani

et al. 2017

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Beta thalassemia is one of the inherited blood diseases in which the production of specific chains in hemoglobin decreases. Esfarlal is a shaltor which is used in these patients as a single dose per day. Since it is prescribed orally, it is easier to tolerate the drug and control the serum iron level of the patient. The aim of this study was to evaluate the efficacy of Osveral in reducing ferritin levels in patients with thalassemia major.Methods: This quasi-experimental study was performed on 48 patients with thalassemia major who referred to Bu-Ali hospital for receiving blood. At the beginning of the study, the required data were collected along with patients' tests including hemoglobin, ferritin, TSH, T4, CBC diff, BUN AST, ALT, BS and creatinine CBC diff. The Osveral drug was prescribed and the patients were evaluated monthly for up to 6 months on the basis of complications. In the first three months after the start of the drug, the serum ferritin level was measured, the dose was adjusted and 6 months after late, the previous tests were again requested, and the auditory and visual examinations were performed, and the information entered the checklist. Data were analyzed using SPSS statistical software.Results: Among all patients, 27 (56.2%) were male and the rest were women with a mean age of 22.22 ± 8.77 years. The results showed that during one year of study, hemoglobin level increased and ferritin level decreased significantly, and other parameters didn’t show significant difference. Nausea and vomiting were the most common complications among patients, which was higher after Osveral than before receiving Osveral.Conclusions: Results showed that Osveral is effective in reducing the level of ferritin in patients with thalassemia major, but control of hematuria is recommended when using this drug.

show abstract

“…9,13,14 Thrombocytopenia and neutropenia may occur, 9,13 and reticulocytopenia, normal macrocytosis, and cellularity of the bone marrow should also be considered besides reduction of erythroid progenitors. 1,15,16,24 Corticosteroid therapy is the main treatment approach to DBA, since a positive response is observed in most cases, 1,5,6 and the disease remains controlled in others for a considerable length of time. 7 Nevertheless, approximately 50% of patients discontinue the treatment due to the loss of clinical efficacy or to secondary effects.…”

mentioning

confidence: 99%

The Stomatological Complications of Diamond-Blackfan Anemia: A Case Report

Gomes

Munerato

2016

Clin Med Res

View full text Add to dashboard Cite

Combination of deferasirox and deferoxamine in clinical practice: An alternative scheme of chelation in thalassemia major patients

Cited by 44 publications

References 17 publications

Effects of deferasirox-deferoxamine on myocardial and liver iron in patients with severe transfusional iron overload

Effects of deferasirox-deferoxamine on myocardial and liver iron in patients with severe transfusional iron overload

Evaluation of Osveral efficacy in reducing ferritin levels in patients with thalassemia major

The Stomatological Complications of Diamond-Blackfan Anemia: A Case Report

Contact Info

Product

Resources

About