Iron chelation treatment with combined therapy with deferiprone and deferioxamine: A 12-month trial

Kattamis, Antonis; Ladis, Vassilios; Berdousi, Helen; Kelekis, Nikolaos; Alexopoulou, Efthymia; Papasotiriou, Ioannis; Drakaki, Kalliopi; Kaloumenou, Irini; Galani, Angeliki; Kattamis, Christos

doi:10.1016/j.bcmd.2005.11.002

Cited by 81 publications

(61 citation statements)

References 19 publications

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“…Moreover, the availability of more than one iron chelators opens up the possibility of reducing iron overload of specific organs while enhancing its overall excretion. 4 Deferasirox is a triazole compound with two molecules of it are needed to bind one molecule of iron fully (tridentate chelator). It has high affinity to iron, with minimal binding to copper and zinc.…”

mentioning

confidence: 99%

Therapeutic Value of Combined Therapy with Deferasirox and Silymarin on Iron Overload in Children with Beta Thalassemia

Hagag¹,

Elfarargy²,

El-Lateef³

2013

JAC

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Abstract. Background: Beta thalassemia is an inherited hemoglobin disorder resulting in a severe, chronic anemia requiring life-long blood transfusion that induces iron overload. Silymarin is a flavonoid complex isolated from Silybin marianum with a strong antioxidant activity, inducing an hepatoprotective action, and probably, a protective effect on iron overload. The aim of this work was to determine the silymarin value in improving iron chelation in thalassemic patients with iron overload treated with Deferasirox. Patients and Methods: This study was conducted on 40 children with beta thalassemia major under follow-up at Hematology Unit, Pediatric Department, Tanta University Hospital with serum ferritin level more than 1000 ng/ml and was divided into two groups. Group IA: Received oral Deferasirox (Exjade) and silymarin for 6 months. Group IB: Received oral Deferasirox (Exjade) and placebo for 6 months and 20 healthy children serving as a control group in the period between April 2011 and August 2012 and was performed after approval from research ethical committee center in Tanta University Hospital and obtaining an informed written parental consent from all participants in this study. Results: Serum ferritin levels were markedly decreased in group IA cases compared with group IB (P= 0.001). Conclusion: From this study we concluded that, silymarin in combination with Exjade can be safely used in the treatment of iron-loaded thalassemic patients as it showed good iron chelation with no sign of toxicity. Recommendations: We recommend extensive multicenter studies in a large number of patients with longer duration of follow-up and more advanced techniques of assessment of iron status in order to clarify the exact role of silymarin in reducing iron overload in children with beta thalassemia.

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confidence: 99%

Therapeutic Value of Combined Therapy with Deferasirox and Silymarin on Iron Overload in Children with Beta Thalassemia

Hagag¹,

Elfarargy²,

El-Lateef³

2013

JAC

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“…Iron balance can be effectively estimated by measuring changes in liver iron concentration (LIC) over time, as LIC is precisely related to body iron stores. 5 Although there have been many observations on the combined use of these chelators showing decreases in serum ferritin (SF), 3,[6][7][8][9][10][11][12][13] relatively few studies have examined changes in LIC.…”

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confidence: 99%

A randomized controlled 1-year study of daily deferiprone plus twice weekly desferrioxamine compared with daily deferiprone monotherapy in patients with thalassemia major

Aydınok¹,

Ülger²,

Nart³

et al. 2007

Haematologica

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“…Improvement in efficacy may be observed by using both compounds almost every day, but this is inconvenient and may increase toxicity. Kattamis et al reported the efficacy and safety of the long-term combined use of deferiprone and deferoxamine in 50 patients with thalassemia [8]. In this study, the regimen was comprised of deferiprone daily and deferoxamine at night on weekends, which provides 70% chelation coverage [8].…”

Section: Iron Chelatorsmentioning

confidence: 96%

“…Various combinations of oral deferiprone and parental deferoxamine have been reported recently [3,[8][9][10]. Improvement in efficacy may be observed by using both compounds almost every day, but this is inconvenient and may increase toxicity.…”

Section: Iron Chelatorsmentioning

confidence: 99%

Iron loading and its clinical implications

Hershko

2007

Am. J. Hematol.

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The main aspects of iron loading and the consequent clinical implications described in this series of articles are summarized in this final chapter. Despite mechanisms to maintain iron homeostasis, harmful iron accumulation can occur in patients with hereditary defects of regulatory proteins, such as hepcidin, or with transfusion‐dependent anemias, such as thalassemia and myelodysplastic syndromes. Identifying the role of nontransferrin bound iron in the pathogenesis of disease allows for better treatment strategies to prevent and reverse iron toxicity. In addition, accurate noninvasive methods to reliably assess iron accumulation and chelation are now available. Continuous chelation coverage, which can be achieved with combination therapy (deferoxamine and deferiprone) or deferasirox, is expected to provide optimal protection from iron toxicity. As more long‐term data on these drugs accumulate, the role of oral and combination chelation therapies in relation to blood transfusion, as well as other iron overload disorders, will become clearer. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.

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Iron chelation treatment with combined therapy with deferiprone and deferioxamine: A 12-month trial

Cited by 81 publications

References 19 publications

Therapeutic Value of Combined Therapy with Deferasirox and Silymarin on Iron Overload in Children with Beta Thalassemia

Therapeutic Value of Combined Therapy with Deferasirox and Silymarin on Iron Overload in Children with Beta Thalassemia

A randomized controlled 1-year study of daily deferiprone plus twice weekly desferrioxamine compared with daily deferiprone monotherapy in patients with thalassemia major

Iron loading and its clinical implications

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