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Randomized Controlled Trial
. 2022 Jun;69(6):e29564.
doi: 10.1002/pbc.29564. Epub 2022 Jan 29.

Comparison of the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy only on iron overload in children and young adults with transfusion-dependent thalassemia: A randomized double-blind placebo-controlled trial

Vineeta Gupta  1 , Ishan Kumar  2 , Vibhesh Raj  1 , Priyanka Aggarwal  1 , Vikas Agrawal  3
Affiliations
Randomized Controlled Trial

Comparison of the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy only on iron overload in children and young adults with transfusion-dependent thalassemia: A randomized double-blind placebo-controlled trial

Vineeta Gupta et al. Pediatr Blood Cancer. 2022 Jun.

Abstract

Background: Myocardial iron deposition is a significant cause of morbidity and mortality in patients with transfusion-dependent thalassemia (TDT). Amlodipine, L-type calcium channel blocker with regular chelation therapy may reduce myocardial iron overload. Lack of randomized trials prompted this study to assess the effect of calcium channel blocker (amlodipine) in combination with iron chelation therapy on iron overload in patients with TDT.

Methods: Sixty-four eligible patients were randomized to receive either amlodipine and chelation (group A) or chelation alone (group B) in double-blind placebo-controlled trial. Myocardial iron concentration (MIC) using T2* magnetic resonance imaging (MRI), liver iron concentration (LIC), left ventricular ejection fraction (LVEF), and serum ferritin were measured at baseline and 12 months.

Results: In the amlodipine group, mean cardiac T2* value significantly increased from 18.11 ± 8.47 to 22.15 ± 7.61 (p = .002) at 12 months, whereas in control group, there was a nonsignificant increase (p = .62) in cardiac T2* value from 19.50 ± 8.84 to 20.03 ± 9.07. There was a significant decrease in MRI-derived MIC in the amlodipine group compared to control group (1.93 ± 1.61 to 1.29 ± 0.90, p = .01). Changes in the LVEF (p = .45), MRI-derived LIC (p = .09), and serum ferritin (p = .81) were not significant between the two groups.

Conclusion: Amlodipine is safe and when combined with chelation therapy appears to be more effective in reducing cardiac iron overload than chelation only in children and young adults with TDT.

Keywords: calcium channel blocker; chelation; iron overload; myocardial iron concentration; thalassemia.

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References

REFERENCES

    1. Balgir RS. The burden of hemoglobinopathies in India and the challenges ahead. Curr Sci. 2000;10:1536-1547.
    1. Borgna-Pignatti C, Gamberini MR. Complications of thalassemia major and their treatment. Expert Rev Hematol. 2011;4(3):353-366.
    1. Aydinok Y, Kattamis A, Cappellini MD, et al. Effects of deferasirox-deferoxamine on myocardial and liver iron in patients with severe transfusional iron overload. Blood. 2015;125(25):3868-3877.
    1. Das SK, Oudit GY. Voltage-gated Ca2+ channels as key mediators of iron transport and iron-overload cardiomyopathy: L-type vs T-type Ca+ channels. Eur J Haematol. 2012;88(6):476-477.
    1. Kumfu S, Chattipakorn SC, Fucharoen S, Chattipakorn N. Dual T-type and L-type calcium channel blocker exerts beneficial effects in attenuating cardiovascular dysfunction in iron-overloaded thalassemic mice. Exp Physiol. 2016;101:521-539.

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