Iron overload is a common complication in pediatric patients with transfusion-dependent hemoglobin disorders. Iron chelators such as deferasirox and deferiprone are effective in treating iron overload. We conducted a systematic review and meta-analysis to determine the efficacy of deferasirox versus deferiprone for treating iron overload in pediatric patients with impaired hemoglobin.
Several modalities to diagnose and monitor iron overload in the body, including examination of serum ferritin levels and MRI, as non-invasive modalities. For the treatment of iron overload, there are iron chelators that can be used, namely injectable deferoxamine, deferasirox, and oral deferiprone.
We conducted a systematic review and meta-analysis to determine the efficacy of deferasirox versus deferiprone for treating iron overload in pediatric patients with impaired hemoglobin. Literature searches were conducted through PubMed and Cochrane Central. Included were randomized clinical trials and observational studies that assessed the efficacy of deferasirox versus deferiprone for treating inherited hemoglobin disorders.
The data included in this systematic review and meta-analysis were from 5 studies with 607 patients. The meta-analysis found no significant difference between deferasirox and deferiprone in MRI T2* at the end of therapy (weighted mean difference/WMD: -0.92; 95% CI -3.35 to 1.52; p= 0, 46). In addition, there was no significant difference in serum ferritin levels at 6 months (WMD: 97.31; 95% CI -236.16 to 430.77; p= 0.57) and 12 months (WMD: 46.99; 95% CI -191.42 to 285.40; p = 0.70) between the two.
This systematic review and meta-analysis concluded that there is no significant difference in the efficacy of deferasirox and deferiprone in managing iron overload in pediatric patients with inherited blood disorders.
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Reference:
1. Saleem A, Waqar E, Shuja SH, Naeem U, Moeed A, Rais H, et al. No difference in myocardial iron concentration and serum ferritin with deferasirox and deferiprone in pediatric patients with hemoglobinopathies: A systematic review and meta-analysis. Clin Biol Transfusion. 2022 doi:10.1016/j.tracli.2022.07.044.
2. Bou-Fakhredin R, Elias J, Taher AT. Iron overload and chelation therapy in hemoglobinopathies. Thalassemia Reports [Internet]. 2018 Apr 18 [cited 2022 Sept 7]. Available from: https://www.pagepressjournals.org/index.php/thal/article/view/7478/7868
