A study to compare the efficacy, safety & economy of oral iron chelators in patients with Thalassaemia major
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 3
Abstract
Background: Thalassemia is an inherited impairment of hemoglobin production, in which there is partial or complete failure to synthesize a specific type of globin chain. It is characterized by ineffective erythropoesis and hemolysis. It requires frequent blood transfusion and so becomes the most common chronic iron overloading disorder. Excess iron deposits may be in various tissues of the body, particularly the liver, heart, and endocrine organs. Materials and Methods: Frequent serum ferritin values at the time of enrolment in the study and after 1, 3, and 6 months were recorded. Serum ferritin was by using Partial Chemiluminescent Axim Abet System method after clinically ruling out any active infection. In this study a total of 73 patients were included, 39 were in Deferasirox group and 34 were in Deferiprone group. Out of these 4 from Deferasirox group and 1 from Deferiprone group were excluded in view of their non-compliance for the regular follow-up. Remaining 68 patients were studied in two groups; 35 in Deferasirox and 33 in Deferiprone group. All these patients were the diagnosed cases of Thalassemia major with more than fifteen blood transfusions in a year. Results: Base line mean ± SD Hemoglobin at the time of enrollment was 7.32 ± 1.5 in Deferasirox group and 7.74 ± 1.07 in Deferiprone group. After 6 months of regular follow up mean hemoglobin was raised significantly to 8.77 ± 0.84 and 8.69 ± 0.9 respectively in both the groups. There were no significant changes in total White blood cells count, creatinine and SGPT level with the six month of study. About 19(28%) patients reported side effects, 14.71 % with Deferasirox and 13.23% with Deferiprone but none of them required interruption of therapy due to them. The adverse events like G.I. upsets including abdominal pain, nausea, vomiting and diarrhea were observed to the extent of 17.14 % with Deferasirox and 12.12% with Deferiprone. Arthralgia was reported by 2.85% patient in Deferasirox group and 12.12 % in Deferiprone group. Skin rashes were observed in three patients (8.57%) in Deferasirox group. For a patient of 20 Kg, per month average acquisition cost of Deferasirox is Rs.1200/ and for Deferiprone is Rs. 620. Conclusion: Thus we conclude that Deferasirox and Deferiprone are well tolerated, have few adverse effects and almost has a comparable effect in lowering of the patient's serum ferritin level. Deferiprone is more cost effective but needs a strict control on compliance owing to requirement in three divided doses per day. However in view of limitations to our study further well designed, randomized controlled trials with better sophisticated parameters of iron load are required to put a final remark on the most appropriate oral iron chelator suitable for the Indian population
Authors and Affiliations
Dr Pankaj Gupta
Limb Salvage Surgery in Bone Tumors: A Single Institutional StudyK.M.I.O Experience
Introduction: Limb salvage surgery is the procedure which helps to remove tumours of Extremities and reconstruction is done with acceptable oncologic, functional and cosmetic results. The first priority is given for onco...
Giant Serous Cyst adenoma of Ovary in an Adolescent Girl: Case Report
Ovarian neoplasia in pediatric population is rare. Serous cystadenoma is an uncommon ovarian tumor in the adolescent age group, arises from surface epithelium of ovary. We report a case of serous cystadenoma of ovary in...
Seroprevalence of HBV HCV HIV and SYPHILIS Infections among Blood Donors in South East Rajasthan- An Eleven Year Retrospective Study
Transfusion of blood and blood products has proven to be an important aid in saving patient’s life thus strengthening patient care but at the same time it could transmit infections to the recipients. We conducted a retro...
Primary Non Hodgkin Lymphoma of Liver: A Rare Diagnosis
Primary non-Hodgkin lymphoma (NHL) of liver is a very rare malignancy. Here we report a case of a 50 year old man presented to us with history of pain upper abdomen for last 2 months. A computed tomography of the abdomen...
Pathways to Psychiatric Care: A Hospital Based Study
Background: Neuropsychiatric disorders account for about 14 % of the global burden of disease.Many people living with mental disorders delay seeking psychiatric care from formal health facilities.This delay is there beca...