Deferasirox versus deferoxamine in managing iron overload in patients with Sickle Cell Anaemia: a systematic review and meta-analysis

J Int Med Res. 2022 Dec;50(12):3000605221143290. doi: 10.1177/03000605221143290.

Abstract

Objectives: To examine the efficacy of deferasirox (DFX) by comparison with deferoxamine (DFO) in managing iron overload in patients with sickle cell anaemia (SCA).

Methods: Online databases were systematically searched for studies published from January 2007 to July 2022 that had investigated the efficacy of DFX compared with DFO in managing iron overload in patients with SCA.

Results: Of the 316 articles identified, three randomized clinical trials met the inclusion criteria. Meta-analysis of liver tissue iron concentration (LIC) showed that iron overload was not significantly higher in the DFX group compared with DFO group (WMD, -1.61 mg Fe/g dw (95% CI -4.42 to 1.21). However, iron overload as measured by serum ferritin was significantly lower in DFO compared with DFX group (WMD, 278.13 µg/l (95% CI 36.69 to 519.57). Although meta-analysis was not performed on myocardial iron concentration due to incomplete data, the original report found no significant difference between DFX and DFO.

Conclusion: While limited by the number of studies included in this meta-analysis, overall, the results tend to show that DFX was as effective as DFO in managing iron overload in patients with SCA.

Keywords: iron overload; liver iron concentration; myocardial iron concentration; serum ferritin; sickle cell anaemia.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / drug therapy
  • Benzoates / therapeutic use
  • Deferasirox / therapeutic use
  • Deferoxamine / therapeutic use
  • Humans
  • Iron
  • Iron Chelating Agents / therapeutic use
  • Iron Overload* / drug therapy
  • Iron Overload* / etiology
  • Triazoles / therapeutic use

Substances

  • Deferasirox
  • Deferoxamine
  • Iron Chelating Agents
  • Benzoates
  • Triazoles
  • Iron