COMPARATIVE EFFICACY OF DIFFERENT ORAL IRON CHELATORS IN MULTIPLY TRANSFUSED THALASSAEMIA PATIENTS

Arakhita Swain*, Kedarnath Das, J. Bikrant Kumar Prusty and Saiprasanna Behera

ABSTRACT

Background: Thalassaemia is not that uncommon disease and it has lots of morbidities and mortalities. Repeated Blood Transfusions at regular intervals, still remains as the treatment of choice due to very many reasons, leading eventually, to iron over loading and its complications. The management of iron overload in these patients requires the administration of iron chelators continuously and evaluation of serum ferritin levels at regular intervals. This study was undertaken in the Department of Pediatrics, S.C.B. Medical College & SVP PGIP, Cuttack, in collaboration with the Department of Clinical Hematology, S.C.B. Medical College, Cuttack, Odisha during the period from January, 2012 to June, 2013 with an aim and objective to compare the efficacy of different oral iron chelators for clinical use. Materials And Methods: The study included 60 patients of Thalassaemia, out of which 50 were β-thalassaemia major and 10 β-Thalassaemia intermedia. Study population (after fulfilling inclusion and exclusion criteria) was divided into two Treatment Groups a) Deferiprone and b) Deferasirox, each consisting of 30 patients chosen randomly, for giving the drug. After detailed history and physical examination, all were investigated, given chilators and re-investigated after 6 months of chelation therapy. During statistical analysis one group acted as the control for the other group. Results: The study included 60 patients of Thalassaemia, out of which 50 were β-thalassaemia major and the rest 10 were β-Thalassaemia intermedia. Treatment Groups a) Deferiprone and b) Deferasirox, each consisted of 30 patients. Out of 60 patients, 42(70%) had significant (≥ 15%) decrease in serum ferritin level, but the decrease was more marked in Deferasirox group (41.7%) than Deferiprone group (28.3%). Conclusion: Even though both Deferiprone and Deferasirox are effective at decreasing iron burden, from the point views of several characteristics, Deferasirox is favoured over Deferiprone.

Keywords: Thalassaemia, Iron Chelators, Multiply Transfused, Ferritin, BT.