[Deferasirox--a new oral iron chelator--review]

Abstract

Deferasirox is a new oral iron chelator. It is the first oral iron chelator approved in USA by FDA for transfusion-dependent patients above 2 years suffering from severe chronic iron overload. It is also recommended as the initial therapy for patients over the age of 6 years who are suffering from beta-thalassaemia. The clinical study is developing in China. This review focuses the related studies and the latest progression about deferasirox. The phase II and III clinical trials and pharmacokinetics indicated that deferasirox is a safety and effective oral iron chelator, can significantly decrease the myocardial and hepatic iron load, also is easy to accept for patients. The common adverse reactions are gastrointestinal symptom and rash. But it was recently reported that deferasirox has some rare adverse events to which we must attach importance, especially for the special people. Besides the patients with chronic iron overload resulting from blood transfusions (transfusional hemosiderosis), the drug is also used for the patients who has accepted auto-SCT or suffered from reversible renal inadequacy caused by Fanconi syndrome. The standard dosage is not useful to every patient. The clinician should adjust dosage based on the patient's condition and related indexes. The serum ferritin is not one and reliable index to monitoring the effect and adjust the dosage. Otherwise, this review recommends some new characters of deferasirox, e.g. anti-fungus, anti-cell proliferation and so on.