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Comparative Study
. 2011 May;86(5):433-6.
doi: 10.1002/ajh.21993.

Iron chelation adherence to deferoxamine and deferasirox in thalassemia

Felicia Trachtenberg  1 , Elliott Vichinsky, Dru Haines, Zahra Pakbaz, Lauren Mednick, Amy Sobota, Janet Kwiatkowski, Alexis A Thompson, John Porter, Thomas Coates, Patricia J Giardina, Nancy Olivieri, Robert Yamashita, Ellis J Neufeld; Thalassemia Clinical Research Network
Affiliations
Comparative Study

Iron chelation adherence to deferoxamine and deferasirox in thalassemia

Felicia Trachtenberg et al. Am J Hematol. 2011 May.

Abstract

The Thalassemia Clinical Research Network collected adherence information from 79 patients on deferoxamine and 186 on deferasirox from 2007 to 2009. Chelation adherence was defined as percent of doses administered in the last 4 weeks (patient report) out of those prescribed(chart review). Chelation history since 2002 was available for 97 patients currently on deferoxamine and 217 on deferasirox, with crude estimates of adherence from chart review. Self-reported adherence to both deferoxamine and deferasirox were quite high, with slightly higher adherence to the oral chelator (97 vs. 92%). Ninety percent of patients on deferasirox reported at least 90% adherence, compared with 75% of patients on deferoxamine. Adherence to both chelators was highest in children, followed by adolescents and older adults.Predictors of lower deferoxamine adherence were smoking in the past year, problems sticking themselves (adults only), problems wearing their pump, and fewer transfusions in the past year. Predictors of lower deferasirox adherence were bodily pain and depression. Switching chelators resulted in increased adherence, regardless of the direction of the switch, although switching from deferoxamine to deferasirox was far more common. As adherence to deferoxamine is higher than previously reported, it appears beneficial for patients to have a choice in chelators.

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Conflict of interest statement

Conflict of interest: Nothing to report

Figures

Figure 1
Figure 1
Chelation adherence by age to (A) deferoxamine and (B) deferasirox.
See this image and copyright information in PMC

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