deferiprone vs deferoxamine in thalassaemia

Inpharma 1352 - 24 Aug 2002 Deferiprone vs deferoxamine in thalassaemia Compared with deferoxamine, deferiprone is more effective in the reduction of myocardial iron levels in patients with β-thalassaemia major, according to researchers from the UK. 1 They retrospectively analysed myocardial iron content and cardiac function from 15 patients with β- thalassaemia major who had been receiving oral deferiprone monotherapy for > 3 years, and compared them with data from 30 matched thalassaemia major controls receiving long-term SC deferoxamine [desferrioxamine]. The deferiprone group had significantly lower myocardial iron levels, compared with the deferoxamine group (median of 34 vs 11.4ms). Deferiprone-treated patients also had significantly enhanced left ventricular ejection fractions and significantly reduced left ventricular dilatations in both systole and diastole, relative to the deferoxamine recipients. However, the deferiprone group had significantly higher levels of iron in the liver, compared with the deferoxamine group. The researchers say that these results ‘emphasise the importance of the variation between organs in iron concentrations and most notably the poor correlation between liver and myocardial iron’. They therefore suggest that it might be necessary to individualise iron- chelation therapy to optimise patient response. In an accompanying editorial, Dr Des Richardson from the Children’s Cancer Research Unit Australia, Sydney, comments that combination treatment with deferiprone and deferoxamine may be superior to monotherapy with either of these drugs. 2 He adds that, ‘considering the number of orally active ligands in development, combination therapy with individualised tailoring of regimens with more than one chelator may be possible’. 1. Anderson LJ, et al. Comparison of effects of oral deferiprone and subcutaneous desferrioxamine on myocardial iron concentrations and ventricular function in beta-thalassaemia. Lancet 360: 516-520, 17 Aug 2002. 2. Richardson DR. Deferiprone: greater efficacy at depleting myocardial than hepatic iron? Lancet 360: 501-502, 17 Aug 2002. 800888521 1 Inpharma 24 Aug 2002 No. 1352 1173-8324/10/1352-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Inpharma 1352 - 24 Aug 2002

Deferiprone vs deferoxamine inthalassaemia

Compared with deferoxamine, deferiprone is moreeffective in the reduction of myocardial iron levels inpatients with β-thalassaemia major, according toresearchers from the UK.1

They retrospectively analysed myocardial iron contentand cardiac function from 15 patients with β-thalassaemia major who had been receiving oraldeferiprone monotherapy for > 3 years, and comparedthem with data from 30 matched thalassaemia majorcontrols receiving long-term SC deferoxamine[desferrioxamine].

The deferiprone group had significantly lowermyocardial iron levels, compared with the deferoxaminegroup (median of 34 vs 11.4ms). Deferiprone-treatedpatients also had significantly enhanced left ventricularejection fractions and significantly reduced leftventricular dilatations in both systole and diastole,relative to the deferoxamine recipients. However, thedeferiprone group had significantly higher levels of ironin the liver, compared with the deferoxamine group.

The researchers say that these results ‘emphasise theimportance of the variation between organs in ironconcentrations and most notably the poor correlationbetween liver and myocardial iron’. They thereforesuggest that it might be necessary to individualise iron-chelation therapy to optimise patient response.

In an accompanying editorial, Dr Des Richardsonfrom the Children’s Cancer Research Unit Australia,Sydney, comments that combination treatment withdeferiprone and deferoxamine may be superior tomonotherapy with either of these drugs.2 He adds that,‘considering the number of orally active ligands indevelopment, combination therapy with individualisedtailoring of regimens with more than one chelator maybe possible’.1. Anderson LJ, et al. Comparison of effects of oral deferiprone and subcutaneous

desferrioxamine on myocardial iron concentrations and ventricular function inbeta-thalassaemia. Lancet 360: 516-520, 17 Aug 2002.

2. Richardson DR. Deferiprone: greater efficacy at depleting myocardial thanhepatic iron? Lancet 360: 501-502, 17 Aug 2002.

800888521

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