Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia
Objectives: Chelating agents remain the mainstay in reducing the iron burden and extending patient survival in homozygous beta-thalassemia but adverse and toxic effects may increase with the institution and long term use of this essential therapy. This study aimed to estimate the incidence of defera...
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| Format: | Article |
| Language: | English |
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Oman Medical Specialty Board
2013-03-01
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| Series: | Oman Medical Journal |
| Subjects: | |
| Online Access: | http://www.omjournal.org/fultext_PDF.aspx?DetailsID=355&type=fultext |
| _version_ | 1819211608354717696 |
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| author | Murtadha Al-Khabori Sunil Bhandari Mohammed Al-Huneini Khalil Al-Farsi Vinodh Panjwani Shahina Daar |
| author_facet | Murtadha Al-Khabori Sunil Bhandari Mohammed Al-Huneini Khalil Al-Farsi Vinodh Panjwani Shahina Daar |
| author_sort | Murtadha Al-Khabori |
| collection | DOAJ |
| description | Objectives: Chelating agents remain the mainstay in reducing the iron burden and extending patient survival in homozygous beta-thalassemia but adverse and toxic effects may increase with the institution and long term use of this essential therapy. This study aimed to estimate the incidence of deferasirox (DFX) side effects in patients with thalassemia major or intermedia.Methods: A retrospective study of 72 patients (mean age: 20.3±0.9 yrs; 36 male, 36 female) with thalassemia major or intermedia treated at Sultan Qaboos University Hospital, Oman, was performed to assess the incidence of side effects related to deferasirox over a mean of 16.7 month follow-up period.Results: Six patients experienced rashes and 6 had gastro-intestinal upset. DFX was discontinued in 18 patients for the following reasons: persistent progressive rise(s) in serum creatinine (7 patients; 40% mean serum creatinine rise from baseline), feeling unwell (2), severe diarrhea (1), pregnancy (1), death unrelated to chelator (2) and rise in serum transaminases (2). Three patients were reverted to desferoxamine and deferiprone combination therapy as DFX was no longer biochemically effective after 18 months of therapy. There was no correlation between baseline serum ferritin and serum creatinine or a rise in serum creatinine. Cardiac MRI T2* did not change with DFX therapy. However, there was an improvement in liver MRI T2* (p=0.013).Conclusion: Renal side effects related to deferasirox appear to be higher than those reported in published clinical trials. Further larger studies are required to confirm these findings. |
| first_indexed | 2024-12-23T06:29:46Z |
| format | Article |
| id | doaj.art-0a36ef661aac40d9931a44ec79b24545 |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-12-23T06:29:46Z |
| publishDate | 2013-03-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-0a36ef661aac40d9931a44ec79b245452022-12-21T17:56:57ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042013-03-01282121124Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or IntermediaMurtadha Al-KhaboriSunil BhandariMohammed Al-HuneiniKhalil Al-FarsiVinodh PanjwaniShahina DaarObjectives: Chelating agents remain the mainstay in reducing the iron burden and extending patient survival in homozygous beta-thalassemia but adverse and toxic effects may increase with the institution and long term use of this essential therapy. This study aimed to estimate the incidence of deferasirox (DFX) side effects in patients with thalassemia major or intermedia.Methods: A retrospective study of 72 patients (mean age: 20.3±0.9 yrs; 36 male, 36 female) with thalassemia major or intermedia treated at Sultan Qaboos University Hospital, Oman, was performed to assess the incidence of side effects related to deferasirox over a mean of 16.7 month follow-up period.Results: Six patients experienced rashes and 6 had gastro-intestinal upset. DFX was discontinued in 18 patients for the following reasons: persistent progressive rise(s) in serum creatinine (7 patients; 40% mean serum creatinine rise from baseline), feeling unwell (2), severe diarrhea (1), pregnancy (1), death unrelated to chelator (2) and rise in serum transaminases (2). Three patients were reverted to desferoxamine and deferiprone combination therapy as DFX was no longer biochemically effective after 18 months of therapy. There was no correlation between baseline serum ferritin and serum creatinine or a rise in serum creatinine. Cardiac MRI T2* did not change with DFX therapy. However, there was an improvement in liver MRI T2* (p=0.013).Conclusion: Renal side effects related to deferasirox appear to be higher than those reported in published clinical trials. Further larger studies are required to confirm these findings.http://www.omjournal.org/fultext_PDF.aspx?DetailsID=355&type=fultextChelatorKidney functionThalassemiaToxicity. |
| spellingShingle | Murtadha Al-Khabori Sunil Bhandari Mohammed Al-Huneini Khalil Al-Farsi Vinodh Panjwani Shahina Daar Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia Oman Medical Journal Chelator Kidney function Thalassemia Toxicity. |
| title | Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia |
| title_full | Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia |
| title_fullStr | Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia |
| title_full_unstemmed | Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia |
| title_short | Side effects of Deferasirox Iron Chelation in Patients with Beta Thalassemia Major or Intermedia |
| title_sort | side effects of deferasirox iron chelation in patients with beta thalassemia major or intermedia |
| topic | Chelator Kidney function Thalassemia Toxicity. |
| url | http://www.omjournal.org/fultext_PDF.aspx?DetailsID=355&type=fultext |
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