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Reduction in labile plasma iron during treatment with deferasirox, a once‐daily oral iron chelator, in heavily iron‐overloaded patients with β ‐thalassaemia
Author(s) -
Daar Shahina,
Pathare Anil,
Nick Hanspeter,
KriemlerKrahn Ulrike,
Hmissi Abdel,
Habr Dany,
Taher Ali
Publication year - 2009
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2008.01204.x
Subject(s) - deferasirox , deferiprone , thalassemia , medicine
This subgroup analysis evaluated the effect of once‐daily oral deferasirox on labile plasma iron (LPI) levels in patients from the prospective, 1‐yr, multicentre ESCALATOR study. Mean baseline liver iron concentration and median serum ferritin levels were 28.6 ± 10.3 mg Fe/g dry weight and 6334 ng/mL respectively, indicating high iron burden despite prior chelation therapy. Baseline LPI levels (0.98 ± 0.82 μmol/L) decreased significantly to 0.12 ± 0.16 μmol/L, 2 h after first deferasirox dose ( P = 0.0006). Reductions from pre‐ to post‐deferasirox administration were also observed at all other time points. Compared to baseline, there was a significant reduction in preadministration LPI that reached the normal range at week 4 and throughout the remainder of the study ( P ≤ 0.02). Pharmacokinetic analysis demonstrated an inverse relationship between preadministration LPI levels and trough deferasirox plasma concentrations. Once‐daily dosing with deferasirox ≥20 mg/kg/d provided sustained reduction in LPI levels in these heavily iron‐overloaded patients, suggesting 24‐h protection from LPI. Deferasirox may therefore reduce unregulated tissue iron loading and prevent further end‐organ damage.