Deferiprone: New insight.
Recent results from independent studies suggest that deferiprone is more cardioprotective than deferoxamine. Patients on long-term treatment with deferiprone have a better myocardial magnetic resonance imaging pattern and less chance to develop a new cardiac disease or worsen an existing one. Most of these observations are retrospective and require confirmation from randomized controlled trials. Other new observations regard the effects of combining the two chelators. Most results indicate an additional effect on iron excretion and a significant reduction of the time required to mitigate severe iron overload and to reverse clinical heart disease. Again, these data require confirmation, as they were mostly obtained on individual cases or small groups of patients treated with a wide range of combinations of the two chelators, but the univocity of results is impressive. After many years of controversy, deferiprone is emerging as a useful oral iron chelator that enhances the chances for the patient to have optimal treatment. Well-designed and -conducted studies will help in answering the questions still open.
Piga
A
A
Department of Pediatric Hematology/Oncology, University of Turin, Turin, Italy. antonio.piga@unito.it
Roggero
S
S
Vinciguerra
T
T
Sacchetti
L
L
Gallo
V
V
Longo
F
F
D000380:Agranulocytosis / Q000139:chemically induced; D009202:Cardiomyopathies / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D000077543:Deferiprone; D003676:Deferoxamine / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007501:Iron / Q000378:metabolism; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019190:Iron Overload / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D007592:Joint Diseases / Q000139:chemically induced; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000139:chemically induced; D009503:Neutropenia / Q000139:chemically induced; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D013789:Thalassemia / Q000150:complications / Q000188:drug therapy* / Q000628:therapy
D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D007501:Iron; D003676:Deferoxamine