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Pharmacokinetics and safety of deferasirox in subjects with chronic kidney disease undergoing haemodialysis
Author(s) -
Maker Garth L,
Siva Brian,
Batty Kevin T,
Trengove Robert D,
Ferrari Paolo,
Olynyk John K
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12035
Subject(s) - deferasirox , medicine , pharmacokinetics , kidney disease , adverse effect , acute kidney injury , hemodialysis , renal function , gastroenterology , pharmacology , urology , thalassemia
Aim Treatment of chronic kidney disease ( CKD ) includes parenteral iron therapy, and these infusions can lead to iron overload. Secondary iron overload is typically treated with iron chelators, of which deferasirox is one of the most promising. However, it has not been studied in patients with CKD and iron overload. Methods A pilot study was conducted to evaluate the pharmacokinetics and safety of deferasirox in eight haemodialysis‐dependent patients, who were receiving intravenous iron for treatment of anaemia of CKD . Deferasirox was administered at two doses (10 mg/kg and 15 mg/kg), either acute (once daily for 2 days) or steady‐state (once daily for 2 weeks). Results A dose of 10 mg/kg in either protocol was not sufficient to achieve a plasma concentration in the therapeutic range (acute peak 14.1 and steady‐state 22.8 μmol/L), while 15 mg/kg in either protocol maintained plasma concentration well above this range (acute peak 216 and steady‐state 171 μmol/L). Plasma concentration observed at 15 mg/kg was well above that expected for this dose (40–50 μmol/L), although no adverse clinical events were observed. Conclusion This study highlights the need to profile drugs such as deferasirox in specific patient groups, such as those with CKD and iron overload.