Efficacy and safety of a novel combination of two oral chelators deferasirox/deferiprone over deferoxamine/deferiprone in severely iron overloaded young beta thalassemia major patients

Elalfy, Mohsen Saleh; Adly, Amira; Wali, Yasser; Tony, Samir; Samir, Ahmad; Elhenawy, Yasmine Ibrahim

doi:10.1111/ejh.12507

Cited by 88 publications

(86 citation statements)

References 35 publications

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“…Many subsequent publications have reported that in comparison with DFO monotherapy, combination therapy and DFX monotherapy have more significant effects on iron overload and myocardial improvement [31, 32]. These findings were similar to recently published data [33] showing that DFP/DFX combination is superior in improving cardiac T2*. Each of these therapies has advantages and shortcomings, and tailoring therapy to individual patients is important for optimizing treatment outcome.…”

Section: Discussionsupporting

confidence: 82%

Effectiveness and Safety of Deferasirox in Thalassemia with Iron Overload: A Meta-Analysis

et al. 2018

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Deferasirox (DFX) has recently been used to treat thalassemia with iron overload; however, its long-term effectiveness and safety await multi-year studies. In this study, a systematic meta-analysis was performed to assess the effectiveness and safety of DFX in the treatment of thalassemia with iron overload. We performed a systematic electronic literature search for randomized controlled studies of DFX in the Embase, Medline, Cochrane, and Chinese Biomedical Literature (CBM) databases from January 1990 to May 2018. Particular attention was paid to mortality, serum ferritin (SF), liver iron concentration (LIC), myocardial iron concentration, and adverse events (AEs). Six studies comparing DFX with deferoxamine (DFO) and placebo were enrolled. DFX was not better than DFO in lowering SF and LIC, with an exception that high DFX dose (> 30 mg/kg/day) was superior to DFO in LIC. Otherwise, AEs such as gastrointestinal problems appeared to be more common with DFX. DFX does not seem to be superior to DFO at low dose. Similar efficacy seems to be achievable depending on dose. However, the convenient oral administration of DFX has a higher compliance rate.

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Section: Discussionsupporting

confidence: 82%

Effectiveness and Safety of Deferasirox in Thalassemia with Iron Overload: A Meta-Analysis

et al. 2018

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“…Combination of oral chelators DFP and DFX, offers the advantage of improved compliance as compared to DFO. The hypothesis is that the administration of thrice daily DFP and once daily DFX, will ensure exposure to chelating agents and suppression of toxic iron species at all times, thus limiting end organ damage [6,8].…”

Section: Discussionmentioning

confidence: 99%

“…The oral combination of DFP and DFX is a potentially attractive option in heavily iron overload patients, particularly in those with a suboptimal response to monotherapy. A recent randomized trial, few case reports and small series have successfully evaluated this combination [4][5][6][7][8]. The purpose of the study was to prospectively record adverse events, including hepatic, renal, and hematological parameters, and to assess iron overload by serial measurement of serum ferritin over a period of 1 year in patients with bthalassemia major on dual oral iron chelators.…”

mentioning

confidence: 99%

The deferiprone and deferasirox combination is efficacious in iron overloaded patients with β‐thalassemia major: A prospective, single center, open‐label study

Totadri

Bansal

Bhatia

et al. 2015

Pediatric Blood & Cancer

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“…The results of our study disagree with their results. 22 Xia et al in a meta-analysis showed that in comparing DFX with DFO, a significant difference was shown on SF level (P=0.003), and there was no difference between DFX and DFO in safety evaluation. The results of this study were similar to our results.…”

Section: -11mentioning

confidence: 99%

Effect of intravenous Deferoxamine concomitant use with blood transfusion on serum ferritin in thalassemia major patients

Fathi

Amani

Araghchin

et al. 2017

Int J Basic Clin Pharmacol

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Background: Subcutaneous Deferoxamineis often not tolerated by patients and its rejection leads to iron overload with its complications. So, other methods with better toleration and reduction of Deferoxamine consumption are necessary. The present study aimed to evaluate the effect of intravenous Deferoxamine infusion during blood transfusion on serum ferritin (SF) in thalassemia major patients.Methods: In a retrospective cross-sectional study, thirty four patients with β-thalassemia major treated with monthly blood transfusion at Bu-Ali hospital in Ardabil city from April 2013 to April 2014, were selected and followed for six months. The mean SF rate and the needed subcutaneous Deferoxamine rates before intervention were considered as baseline. All patients received intravenous Deferoxamine concomitant with their routine monthly blood transfusion for six months. After six months mean values for ferritin, subcutaneous Deferoxamine were compared with baseline values. Collected data were analyzed using t-test and paired t-test by SPSS, version 18.P<0.05 was considered as significant.Results: Compared with baseline, the subcutaneous Deferoxamine rate and ferritin level have been decreased significantly after intervention.Conclusions: Intravenous Deferoxamine concomitant use with routine monthly blood transfusion in thalassemia major patients can lead to decreasing of ferritin level. With this method, patient care could be improved, health care costs and complications of treatment effectively reduced.

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Efficacy and safety of a novel combination of two oral chelators deferasirox/deferiprone over deferoxamine/deferiprone in severely iron overloaded young beta thalassemia major patients

Abstract: Both iron chelation combination regimens were equally effective in reducing iron overload and improving QoL.DFP/DFX combination proved superior in improving cardiac T2*, treatment compliance, and patients satisfaction with no greater adverse events.

Cited by 88 publications

References 35 publications

Effectiveness and Safety of Deferasirox in Thalassemia with Iron Overload: A Meta-Analysis

Effectiveness and Safety of Deferasirox in Thalassemia with Iron Overload: A Meta-Analysis

The deferiprone and deferasirox combination is efficacious in iron overloaded patients with β‐thalassemia major: A prospective, single center, open‐label study

Effect of intravenous Deferoxamine concomitant use with blood transfusion on serum ferritin in thalassemia major patients

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