BETA THALASSEMIA MAJOR;

COMPARISON OF DEFERASIROX VERSUS DESFERRIOXAMINE AS IRON CHELATOR IN MULTITRANSFUSED PATIENTS

Abstract

Introduction: β-Thalassemia major (β-TM) is a genetic haemoglobin disorder
which is relatively common in some geographical areas. β-TM is characterized by severe anaemia,
which needs a continuous blood transfusion regimen starting from the first months of life to
prolong survival. Objectives: To compare mean reduction in serum ferritin level with deferasirox
and desferrioxamine when used as an iron chelator in multi-transfused beta thalassemia major.
Study design: Randomized controlled trial. Setting: Thalassemia clinic, The Children’s Hospital
and The Institute of Child Health, Lahore. Duration of Study with Dates: Study was carried out
over a period of nine months from 28-06-2015 to 27-03-2016. Subjects and Methods: A total
of 100 patients (50 patients in each group). The patients were randomly allocated into two
groups using random numbers stable. Group-A received Deferasirox and group-B received
Desferrioxamine. Results: Mean age of the patients was 7.42±4.13 and 7.87±4.13 in group-A
and B, respectively. Regarding sex distribution, 26 patients (52.0%) in group-A and 28 patients
(56.0%) in group-B were male while 24 patients (48.0%) in group-A and 22 patients (44.0%) in
group-B were female. Reduction from baseline in group-A was 783.60±413.66 ng/ml and in
group-B 552.80±155.45 ng/ml (P<0.001) There was more reduction in group-A. In group-A
baseline serum ferritin level was 2495.00±1259.10 ng/ml and at 9 month 1712.00±1019.36 ng/
ml (P<0.001). Similarly in group-B baseline serum ferritin level was 2422.80±910.43 ng/ml and
at 9 month 1883±862.72 ng/ml (P<0.001). Conclusion: In conclusion, deferasirox was more
effective in terms of reduction in serum ferritin level when compared with desferrioxamine in
multi-transfused beta thalassemia major patients.