Effect of deferasirox (ICL670) on arterial function in patients with beta-thalassaemia major.
Deferasirox (ICL670) has been shown to have rapid accessibility to intracellular labile iron. We tested the hypothesis that oral deferasirox improves arterial dysfunction in patients with beta-thalassaemia major. Nineteen thalassaemia patients, aged 23 +/- 7 years, with normal left ventricular (LV) function were treated with deferasirox at 25-35 mg/kg/d for 12 months. LV function, brachial arterial flow-mediated dilation (FMD), carotid arterial stiffness, and serum ferritin levels were determined at baseline prior to initiation, after 6 months and after 12 months of therapy. The baseline cardiovascular indices were compared with those of 17 age-matched controls. Longitudinal changes in patients during the treatment period were also determined. Compared with controls, patients had similar echocardiographic indices of LV function (all P > 0.05), while their baseline brachial FMD was reduced (P < 0.001) and carotid stiffness increased (P = 0.019). An increase in FMD (P < 0.001) and a decrease in carotid stiffness (P = 0.007) were found at 6 and 12 months follow-up. The stiffness index correlated inversely with FMD (r = -0.42, P = 0.001). Although there was an increase in ferritin level at 12 months (3303 +/- 1185 ng/ml vs. 2714 +/- 780 ng/ml at baseline, P = 0.006), no significant correlation existed between ferritin level and FMD or carotid stiffness. In conclusion, deferasirox therapy in thalassaemia patients is associated with improved arterial function.
Cheung
Y F
YF
Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Hong Kong, China. xfcheung@hkucc.hku.hk
Chan
Godfrey C F
GC
Ha
S Y
SY
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000187:drug effects* / Q000503:physiopathology; D001565:Benzoates / Q000494:pharmacology*; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D002339:Carotid Arteries / Q000187:drug effects / Q000503:physiopathology; D000077588:Deferasirox; D004548:Elasticity / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007502:Iron Chelating Agents / Q000494:pharmacology*; D008297:Male; D014230:Triazoles / Q000494:pharmacology*; D014664:Vasodilation / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects; D017086:beta-Thalassemia / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*
D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D000077588:Deferasirox