IMEMR
EMRO
66.92
Index Copernicus
ICICICICICICICIC
Volume 1, Issue 4 (2020)
J Clinic Care Skill 2020, 1(4): 189-193 |
Back to browse issues page
Article Type:
History
Received: 2019/12/11 | Accepted: 2020/07/23 | Published: 2020/07/23
Received: 2019/12/11 | Accepted: 2020/07/23 | Published: 2020/07/23
How to cite this article
Arya A, Jokar S, Etemadfar P, Malekzadeh J, Jannesar R, Rohani M, et al . Comparison of Deferoxamine, Deferiprone and Deferasirox Iron-Chelating Agents in Reducing Serum Ferritin Levels in Patients with Thalassemia Major. J Clinic Care Skill 2020; 1 (4) :189-193
URL: http://jccs.yums.ac.ir/article-1-80-en.html
URL: http://jccs.yums.ac.ir/article-1-80-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Authors
A. Arya1, S. Jokar1, P. Etemadfar2, J.M. Malekzadeh3, R. Jannesar4, M. Rohani5, T. Mohamadi4, F. Kharaman6, M. Yosefi6, S. Hatamipour5, A. Roozbehi *7
1- Internal Medicine Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
2- Paediatric Hematology & Oncology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
3- Nutrition Department, Health Sciences Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
4- Molecular Microbiology Department, Dena Pathobiology Laboratory, Yasuj, Iran
5- Obstetrics & Gynecology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
6- Nursing Care Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
7- Anatomy Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
2- Paediatric Hematology & Oncology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
3- Nutrition Department, Health Sciences Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
4- Molecular Microbiology Department, Dena Pathobiology Laboratory, Yasuj, Iran
5- Obstetrics & Gynecology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
6- Nursing Care Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
7- Anatomy Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
Abstract (2373 Views)
Aims: Patients with thalassemia major suffer from iron overload due to excessive cell lysis. Iron-chelating agents are used to preventing the effects of iron overload on the body. Deferoxamine, deferiprone, and deferasirox are the most common iron-chelating agents. The aim of this study was to compare deferoxamine, deferiprone, and deferasirox iron-chelating agents in reducing serum ferritin levels in patients with thalassemia major.
Instrument & Methods: This descriptive cross-sectional study was performed on 114 thalassemia major patients in the Cooley's ward of Shahid Beheshti Hospital, Yasuj, Iran, in 2018 who had been taking iron supplements for the past year. Census sampling was done. After recording patients’ information, such as age, sex, and type of iron used, the blood sample was taken from the patients to measure serum ferritin and the results were analyzed using SPSS 22 software and multivariate analysis of variance.
Findings: The mean serum ferritin level was 3438.70±2872.88 ng/ml. 14 patients were taking deferoxamine, 62 patients were using deferiprone, and 38 patients were consuming deferasirox. There was no significant difference between iron-chelating agents in reducing ferritin levels (p>0.05). Also, there was no significant difference between males and females in terms of decreased ferritin levels (p>0.05).
Conclusion: There is no difference between deferoxamine, deferiprone and deferasirox iron-chelating agents in reducing the ferritin levels of patients with thalassemia and all can be administrated considering the cost, availability, condition, and patient's desire.
Instrument & Methods: This descriptive cross-sectional study was performed on 114 thalassemia major patients in the Cooley's ward of Shahid Beheshti Hospital, Yasuj, Iran, in 2018 who had been taking iron supplements for the past year. Census sampling was done. After recording patients’ information, such as age, sex, and type of iron used, the blood sample was taken from the patients to measure serum ferritin and the results were analyzed using SPSS 22 software and multivariate analysis of variance.
Findings: The mean serum ferritin level was 3438.70±2872.88 ng/ml. 14 patients were taking deferoxamine, 62 patients were using deferiprone, and 38 patients were consuming deferasirox. There was no significant difference between iron-chelating agents in reducing ferritin levels (p>0.05). Also, there was no significant difference between males and females in terms of decreased ferritin levels (p>0.05).
Conclusion: There is no difference between deferoxamine, deferiprone and deferasirox iron-chelating agents in reducing the ferritin levels of patients with thalassemia and all can be administrated considering the cost, availability, condition, and patient's desire.
Keywords:
Thalassemia Major [MeSH], Iron Chelating Agents [MeSH], Deferoxamine [MeSH], Deferiprone [MeSH], Deferasirox [MeSH], Ferritin [MeSH]
References
1. Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010;5(1):1-15. [link] [DOI:10.1186/1750-1172-5-11] [PMID] [PMCID]
2. Rother RP, Bell L, Hillmen P, Gladwin MT. The clinical sequelae of intravascular hemolysis and extracellular plasma hemoglobin: a novel mechanism of human disease. JAMA. 2005;293(13):1653-62. [link] [DOI:10.1001/jama.293.13.1653] [PMID]
3. Hill QA, Hill A, Berentsen S. Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment. Blood Adv. 2019;3(12):1897-906. [link] [DOI:10.1182/bloodadvances.2019000036] [PMID] [PMCID]
4. Lang N, Reibke R. Durch β-Thalassaemia minor maskierte autoimmune perniziöse Anämie. DMW-Deutsche Medizinische Wochenschrift. 2007;132(40):2083-4. [link] [DOI:10.1055/s-2007-985645] [PMID]
5. Hoffbrand AV, Taher A, Cappellini MD. How I treat transfusional iron overload. Blood. 2012;120(18):3657-69. [link] [DOI:10.1182/blood-2012-05-370098] [PMID]
6. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. 19th Edition. New York: McGraw Hill; 2015. p. 640-9. [link]
7. Hershko C, Link G, Cabantchik I. Pathophysiology of iron overload. Ann N Y Acad Sci. 1998. 850(1):191-201. [link] [DOI:10.1111/j.1749-6632.1998.tb10475.x] [PMID]
8. Cappellini MD, Cohen A, Piga A, Bejaoui M, Perrotta S, Agaoglu L, et al. A phase 3 study of deferasirox (ICL670), a once-daily oral iron chelator, in patients with β-thalassemia. Blood, 2006;107(9):3455-62. [link] [DOI:10.1182/blood-2005-08-3430] [PMID]
9. Allain P, Mauras Y, Chaleil D, Simon P, Ang KS, Cam G, et al. Pharmacokinetics and renal elimination of desferrioxamine and ferrioxamine in healthy subjects and patients with haemochromatosis. Br J Clin Pharmacol. 1987;24(2):207-12. [link] [DOI:10.1111/j.1365-2125.1987.tb03163.x] [PMID] [PMCID]
10. Galanello R, Piga A, Alberti D, Rouan MC, Bigler H, Séchaud R. Safety, tolerability, and pharmacokinetics of ICL670, a new orally active iron‐chelating agent in patients with transfusion‐dependent iron overload due to β‐thalassemia. J Clin Pharmacol. 2003;43(6):565-72. [link] [DOI:10.1177/0091270003253350]
11. Aydinok Y, Kattamis A, Viprakasit V. Current approach to iron chelation in children. Br J Haematol. 2014;165(6):745-55. [link] [DOI:10.1111/bjh.12825] [PMID]
12. Musallam KM, Angastiniotis M, Eleftheriou A, Porter JB. Cross-talk between available guidelines for the management of patients with beta-thalassemia major. Acta Haematol. 2013;130(2):64-73. [link] [DOI:10.1159/000345734] [PMID]
13. Maggio A. Light and shadows in the iron chelation treatment of haematological diseases. Br J Haematol. 2007;138(4):407-21. [link] [DOI:10.1111/j.1365-2141.2007.06666.x] [PMID]
14. Taher A, Al Jefri A, Elalfy MS, Al Zir K, Daar S, Rofail D, et al. Improved treatment satisfaction and convenience with deferasirox in iron-overloaded patients with β-thalassemia: results from the ESCALATOR trial. Acta Haematol. 2010;123(4):220-5. [link] [DOI:10.1159/000313447] [PMID]
15. Sarigianni M, Liakos A, Vlachaki E, Paschos P, Athanasiadou E, Montori VM, et al. Accuracy of magnetic resonance imaging in diagnosis of liver iron overload: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2015;13(1):55-63. e5. [link] [DOI:10.1016/j.cgh.2014.05.027] [PMID]
16. Borgna-Pignatti C, Marsella M. Iron chelation in thalassemia Major. Clin Ther. 2015;37(12):2866-77. [link] [DOI:10.1016/j.clinthera.2015.10.001] [PMID]
17. Neufeld EJ. Oral chelators deferasirox and deferiprone for transfusional iron overload in thalassemia major: new data, new questions. Blood. 2006;107(9):3436-41. [link] [DOI:10.1182/blood-2006-02-002394] [PMID] [PMCID]
18. Pennell D J, Porter JB, Cappellini MD, El-Beshlawy A, Chan LL, Aydinok Y, et al. Efficacy of deferasirox in reducing and preventing cardiac iron overload in β-thalassemia. Blood. 2010;115(12):2364-71. [link] [DOI:10.1182/blood-2009-04-217455] [PMID]
19. Porter JB, Shah FT. Iron overload in thalassemia and related conditions: therapeutic goals and assessment of response to chelation therapies. Hematol Oncol Clin North Am. 2010:24(6):1109-30. [link] [DOI:10.1016/j.hoc.2010.08.015] [PMID]
20. Goel H, Girisha KM, Phadke SR. Long-term efficacy of oral deferiprone in management of iron overload in beta thalassemia major. Hematology. 2008;13(2):77-82. [link] [DOI:10.1179/102453308X315924] [PMID]
21. Borgna-Pignatti C, Cappellini MD, De Stefano P, Del Vecchio GC, Forni GL, Gamberini MR, et al. Cardiac morbidity and mortality in deferoxamine-or deferiprone-treated patients with thalassemia major. Blood. 2006;107(9):3733-7. [link] [DOI:10.1182/blood-2005-07-2933] [PMID]
22. Maggio A, D'Amico G, Morabito A, Capra M, Ciaccio C, Cianciulli P, et al. Deferiprone versus deferoxamine in patients with thalassemia major: a randomized clinical trial. Blood Cells Mol Dis. 2002;28(2):196-208. [link] [DOI:10.1006/bcmd.2002.0510] [PMID]
23. Mourad FH, Hoffbrand AV, Sheikh‐Taha M, Koussa S, Khoriaty AI, Taher A. Comparison between desferrioxamine and combined therapy with desferrioxamine and deferiprone in iron overloaded thalassaemia patients. Br J Haematol. 2003;121(1):187-9. [link] [DOI:10.1046/j.1365-2141.2003.04240.x] [PMID]
24. Hajigholami A, Ansari H, Honarmand S. Comparing the efficacy of Dexeroyx (Osveral) and Deferoxamine (Desferal) in reducing serum ferritin level in patients with thalassemia major. Middle East J Fam Med. 2018;7(10):218-22. [link] [DOI:10.5742/MEWFM.2018.93265]
25. Borgna-Pignatti C, Rugolotto S, De Stefano P, Zhao H, Cappellini MD, Del Vecchio GC, et al. Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica. 2004;89(10):1187-93. [link]