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Evidence summaries

Desferrioxamine Mesylate for Iron Overload in Transfusion-Dependent Thalassaemia

Iron chelation with desferrioxamine appears to be beneficial in people with transfusion-dependent thalassaemia but the optimal schedule remains uncertain. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 8 studies, with a total of 334 subjects, comparing desferrioxamine with placebo (1 trial) or with another iron chelator (deferiprone, 5 trials), or comparing different schedules of desferrioxamine (2 trials). Compared to placebo, desferrioxamine significantly reduced iron overload. The number of deaths at 12 years follow up and evidence of reduced end-organ damage was less for desferrioxamine than placebo. In comparisons to deferiprone or between the different schedules there were no statistically significant differences in measures of iron overload. There was evidence of adverse events in all treatment groups. In one trial, adverse events were significantly less likely with desferrioxamine than deferiprone, relative risk 0.45 (95% confidence interval 0.24 to 0.84).

Comment: The quality of evidence is downgraded by imprecise data (limited study size for each comparison).

    References

    • Roberts DJ, Rees D, Howard J, Hyde C, Alderson P, Brunskill S. Desferrioxamine mesylate for managing transfusional iron overload in people with transfusion-dependent thalassaemia. Cochrane Database Syst Rev 2005 Oct 19;(4):CD004450. [PubMed]

Primary/Secondary Keywords