Clinical efficacy and safety evaluation of tailoring iron chelation practice in thalassaemia patients from Asia-Pacific: A subanalysis of the EPIC study of deferasirox
Journal
International Journal of Hematology
Journal Volume
93
Journal Issue
3
Pages
319-328
Date Issued
2011
Author(s)
Viprakasit, Vip
Ibrahim, Hishamshah
Ha, Shau-Yin
Ho, Phoebe Joy
Li, Chi-Kong
Chan, Lee-Lee
Chiu, Chang-Fang
Sutcharitchan, Pranee
Habr, Dany
Domokos, Gabor
Roubert, Bernard
Xue, Hong-Ling
Bowden, Donald K.
Abstract
Although thalassaemia is highly prevalent in the Asia-Pacific region, clinical data on efficacy and safety profiles of deferasirox in patients from this region are rather limited. Recently, data from the multicentre Evaluation of Patients' Iron Chelation with Exjade (EPIC) study in 1744 patients with different anaemias has provided an opportunity to analyse 1115 thalassaemia patients, of whom 444 patients were from five countries in the Asia-Pacific region (AP) for whom thalassaemia management and choice of iron chelators were similar. Compared to the rest of the world (ROW), baseline clinical data showed that the AP group appeared to be more loaded with iron (3745.0 vs. 2822.0 ng/ml) and had a higher proportion on deferoxamine monotherapy prior to the study (82.9 vs. 58.9%). Using a starting deferasirox dose based on transfusional iron intake and tailoring it to individual patient response, clinical efficacy based on serum ferritin reduction in AP and ROW thalassaemia patients was similar. Interestingly, the AP group developed a higher incidence of drug-related skin rash compared to ROW (18.0 vs. 7.2%), which may indicate different pharmacogenetic backgrounds in the two populations. Our analysis confirms that, with appropriate adjustment of dose, deferasirox can be clinically effective across different regions, with manageable side effects. ? The Japanese Society of Hematology 2011.
Subjects
Asia-Pacific; Iron chelation therapy; Serum ferritin; Skin rash; Thalassaemia
SDGs
Other Subjects
alanine aminotransferase; aspartate aminotransferase; creatinine; deferasirox; deferiprone; deferoxamine; ferritin; abdominal pain; adolescent; alanine aminotransferase blood level; article; aspartate aminotransferase blood level; child; creatinine blood level; cytopenia; diarrhea; drug dose increase; drug dose reduction; drug efficacy; drug hypersensitivity; drug safety; drug tolerability; ear disease; eye disease; female; ferritin blood level; human; iron chelation; iron intake; liver function test; major clinical study; male; monotherapy; nausea; preschool child; rash; school child; side effect; thalassemia; treatment response; Adolescent; Adult; Asia, Southeastern; Benzoic Acids; Child; Child, Preschool; Female; Ferritins; Humans; Iron Chelating Agents; Male; Thalassemia; Triazoles
Type
journal article