Abstract
Iron chelating agents - deferoxamine (DFO), deferiprone (DFP), and deferasirox (DFX) - are used to treat chronic iron overload in patients with β-thalassemia in an attempt to reduce morbidity and mortality related to siderosis. Each of the approved iron chelating agents has its own advantages over the others and also has its own risks, whether related to over-chelation or not. In this review, we briefly discuss the methods to monitor the efficacy of iron chelation therapy (ICT) and the evidence behind the use of each iron chelating agent. We also portray the risks and complications associated with each iron chelating agent and recommend strategies to manage adverse events.
Keywords:
Thalassemia; beta-thalassemia; deferasirox; deferiprone; deferoxamine; iron chelation therapy; iron overload; safety.
MeSH terms
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Benzoates / administration & dosage
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Benzoates / adverse effects
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Benzoates / therapeutic use
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Chelation Therapy*
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Deferasirox
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Deferiprone
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Deferoxamine / administration & dosage
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Deferoxamine / adverse effects
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Deferoxamine / therapeutic use
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Disease Management
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Drug-Related Side Effects and Adverse Reactions
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Female
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Ferritins / blood
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Humans
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Iron / metabolism
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Iron Chelating Agents / administration & dosage
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Iron Chelating Agents / adverse effects
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Iron Chelating Agents / therapeutic use*
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Iron Overload / diagnosis
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Iron Overload / drug therapy*
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Iron Overload / etiology*
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Liver / drug effects
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Liver / metabolism
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Liver / pathology
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Magnetic Resonance Imaging
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Male
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Myocardium / metabolism
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Myocardium / pathology
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Pregnancy
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Pyridones / administration & dosage
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Pyridones / adverse effects
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Pyridones / therapeutic use
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Triazoles / administration & dosage
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Triazoles / adverse effects
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Triazoles / therapeutic use
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beta-Thalassemia / complications*
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beta-Thalassemia / diagnosis
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beta-Thalassemia / therapy
Substances
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Benzoates
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Iron Chelating Agents
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Pyridones
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Triazoles
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Deferiprone
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Ferritins
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Iron
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Deferoxamine
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Deferasirox