Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia

Cardiac iron overload causes most deaths in beta-thalassemia major. The efficacy of deferasirox in reducing or preventing cardiac iron overload was assessed in 192 patients with beta-thalassemia in a 1-year prospective, multicenter study. The cardiac iron reduction arm (n = 114) included patients wi...

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Main Authors: Pennell, D.J., Porter, J.B., Cappellini, M.D., El-Beshlawy, A., Chan, L.L., Aydinok, Y., Elalfy, M.S., Sutcharitchan, P., Li, C.K., Ibrahim, H., Viprakasit, V., Kattamis, A., Smith, G., Habr, D., Domokos, G., Roubert, B., Taher, A.
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Published: 2010
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Online Access:http://eprints.um.edu.my/14976/
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author Pennell, D.J.
Porter, J.B.
Cappellini, M.D.
El-Beshlawy, A.
Chan, L.L.
Aydinok, Y.
Elalfy, M.S.
Sutcharitchan, P.
Li, C.K.
Ibrahim, H.
Viprakasit, V.
Kattamis, A.
Smith, G.
Habr, D.
Domokos, G.
Roubert, B.
Taher, A.
author_facet Pennell, D.J.
Porter, J.B.
Cappellini, M.D.
El-Beshlawy, A.
Chan, L.L.
Aydinok, Y.
Elalfy, M.S.
Sutcharitchan, P.
Li, C.K.
Ibrahim, H.
Viprakasit, V.
Kattamis, A.
Smith, G.
Habr, D.
Domokos, G.
Roubert, B.
Taher, A.
author_sort Pennell, D.J.
building UM Library
collection Institutional Repository
content_provider Universiti Malaya
content_source UM Research Repository
continent Asia
country Malaysia
description Cardiac iron overload causes most deaths in beta-thalassemia major. The efficacy of deferasirox in reducing or preventing cardiac iron overload was assessed in 192 patients with beta-thalassemia in a 1-year prospective, multicenter study. The cardiac iron reduction arm (n = 114) included patients with magnetic resonance myocardial T2* from 5 to 20 ms (indicating cardiac siderosis), left ventricular ejection fraction (LVEF) of 56% or more, serum ferritin more than 2500 ng/mL, liver iron concentration more than 10 mg Fe/g dry weight, and more than 50 transfused blood units. The prevention arm (n = 78) included otherwise eligible patients whose myocardial T2* was 20 ms or more. The primary end point was the change in myocardial T2* at 1 year. In the cardiac iron reduction arm, the mean deferasirox dose was 32.6 mg/kg per day. Myocardial T2* (geometric mean +/- coefficient of variation) improved from a baseline of 11.2 ms (+/- 40.5%) to 12.9 ms (+/- 49.5%) (+ 16%; P < .001). LVEF (mean +/- SD) was unchanged: 67.4 (+/- 5.7%) to 67.0 (+/- 6.0%) (-0.3%; P = .53). In the prevention arm, baseline myocardial T2* was unchanged from baseline of 32.0 ms (+/- 25.6%) to 32.5 ms (+/- 25.1%) (+ 2%; P = .57) and LVEF increased from baseline 67.7 (+/- 4.7%) to 69.6 (+/- 4.5%) (+ 1.8%; P < .001). This prospective study shows that deferasirox is effective in removing and preventing myocardial iron accumulation. This study is registered at http://clinicaltrials.gov as NCT00171821. (Blood. 2010; 115: 2364-2371)
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spelling my.um.eprints-149762015-12-01T00:57:39Z http://eprints.um.edu.my/14976/ Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia Pennell, D.J. Porter, J.B. Cappellini, M.D. El-Beshlawy, A. Chan, L.L. Aydinok, Y. Elalfy, M.S. Sutcharitchan, P. Li, C.K. Ibrahim, H. Viprakasit, V. Kattamis, A. Smith, G. Habr, D. Domokos, G. Roubert, B. Taher, A. R Medicine Cardiac iron overload causes most deaths in beta-thalassemia major. The efficacy of deferasirox in reducing or preventing cardiac iron overload was assessed in 192 patients with beta-thalassemia in a 1-year prospective, multicenter study. The cardiac iron reduction arm (n = 114) included patients with magnetic resonance myocardial T2* from 5 to 20 ms (indicating cardiac siderosis), left ventricular ejection fraction (LVEF) of 56% or more, serum ferritin more than 2500 ng/mL, liver iron concentration more than 10 mg Fe/g dry weight, and more than 50 transfused blood units. The prevention arm (n = 78) included otherwise eligible patients whose myocardial T2* was 20 ms or more. The primary end point was the change in myocardial T2* at 1 year. In the cardiac iron reduction arm, the mean deferasirox dose was 32.6 mg/kg per day. Myocardial T2* (geometric mean +/- coefficient of variation) improved from a baseline of 11.2 ms (+/- 40.5%) to 12.9 ms (+/- 49.5%) (+ 16%; P < .001). LVEF (mean +/- SD) was unchanged: 67.4 (+/- 5.7%) to 67.0 (+/- 6.0%) (-0.3%; P = .53). In the prevention arm, baseline myocardial T2* was unchanged from baseline of 32.0 ms (+/- 25.6%) to 32.5 ms (+/- 25.1%) (+ 2%; P = .57) and LVEF increased from baseline 67.7 (+/- 4.7%) to 69.6 (+/- 4.5%) (+ 1.8%; P < .001). This prospective study shows that deferasirox is effective in removing and preventing myocardial iron accumulation. This study is registered at http://clinicaltrials.gov as NCT00171821. (Blood. 2010; 115: 2364-2371) 2010 Article PeerReviewed Pennell, D.J. and Porter, J.B. and Cappellini, M.D. and El-Beshlawy, A. and Chan, L.L. and Aydinok, Y. and Elalfy, M.S. and Sutcharitchan, P. and Li, C.K. and Ibrahim, H. and Viprakasit, V. and Kattamis, A. and Smith, G. and Habr, D. and Domokos, G. and Roubert, B. and Taher, A. (2010) Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia. Blood, 115 (12). pp. 2364-2371.
spellingShingle R Medicine
Pennell, D.J.
Porter, J.B.
Cappellini, M.D.
El-Beshlawy, A.
Chan, L.L.
Aydinok, Y.
Elalfy, M.S.
Sutcharitchan, P.
Li, C.K.
Ibrahim, H.
Viprakasit, V.
Kattamis, A.
Smith, G.
Habr, D.
Domokos, G.
Roubert, B.
Taher, A.
Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title_full Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title_fullStr Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title_full_unstemmed Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title_short Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
title_sort efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia
topic R Medicine
url http://eprints.um.edu.my/14976/
url_provider http://eprints.um.edu.my/