Combined Therapy with Deferiprone and Desferrioxamine as Compared to Desferasirox on Ventricular Function in Thalassemia Major Patients

Myocardial iron overload is the leading cause of death in patients with beta-thalassemia major.Combined therapy with deferiprone(DFP) and desferrioxamine (DFO)were suggested to be more effective than deferasirox(DFX) for removing heart iron. Deferasirox has recently been made available but its long-term efficacy on cardiac function has not yet been established. Our study aimed to compare the effectiveness of deferiproneanddesferrioxaminewith deferasiroxon ventricular function in thalassemia major patients.

In this clinical trialstudy,72thalassemia major (TM) patients were randomised to receive either deferipronecombined with desferrioxamineanddeferasirox, and thencardiac function were evaluated. Data were analysed for left ventricular ejection fractions(LVEF)at baselinebyechocardiograpy, following 12 months of treatment.

72 TM patientswere enrolled in this study lasting 12 months,36 TMwere placed on DFP/DFO (DFP,50–86 mg/kg body weight; DFO, 24–52 mg/kg body weigh),36received DFX(range 18–40 mg/kg body weight).In 36 patients receiving combined therapy, left ventricular ejection fractionincreased from 59.3+/-5.7% to 63.7+/-5.1% (p=0.001) over 12 months [baseline LVEF values 56-61%]. deferasirox showed no change in LVEF (p = 0.93).We found improvement of left ventricular ejection fractionsin the deferiprone combined with desferrioxamine versus the deferasirox group (P = 0.008).

The patients treated with combined therapy with deferiprone and desferrioxamineshowed better systolic ventricular function compared to the patients treated with deferasirox.The patients treated with combined therapy with deferiprone and desferrioxamine showed better systolic ventricular function compared to the patients treated with deferasirox.