Deferasirox for managing iron overload in people with myelodysplastic syndrome.
BACKGROUND
The myelodysplastic syndrome (MDS) comprises a diverse group of haematopoietic stem cell disorders. Due to symptomatic anaemia most patients require supportive therapy including repeated red blood cell (RBC) transfusions. In combination with increased iron absorption, this contributes to the accumulation of iron resulting in secondary iron overload and the risk of organ dysfunction and reduced life expectancy. Since the human body has no natural means of getting rid of excess iron, iron chelation therapy is usually recommended. However, whether the new oral chelator deferasirox leads to relevant benefit is unclear.


OBJECTIVE
To assess the effectiveness and safety of oral deferasirox in people with myelodysplastic syndrome and iron overload.


METHODS
We searched MEDLINE, EMBASE, The Cochrane Library, Biosis Previews, Web of Science, Derwent Drug File, XTOXLINE and three trial registries: Current Controlled Trials: www.controlled-trials.com, ClinicalTrials.gov: www.clinicaltrials.gov, ICTRP: www.who.int./ictrp/en/. Most recent searches of these databases: June 2010.


METHODS
Randomised controlled trials comparing deferasirox with no therapy/placebo or with another iron chelating treatment schedule.


METHODS
No studies eligible for inclusion in this review were identified.


RESULTS
No studies were included in this review. However, we identified one ongoing study comparing deferasirox with deferoxamine.


CONCLUSIONS
We planned to report evidence from randomised clinical trials evaluating the effectiveness of deferasirox compared to either placebo/no treatment or other chelating regimens such as deferoxamine in people with myelodysplastic syndrome. However, no completed randomised trials addressing this question could be identified.One ongoing randomised study comparing deferasirox with placebo was identified and preliminary data will hopefully be available soon. These results will be important to inform physicians and patients on the advantages and disadvantages of this treatment option.
German Cochrane Centre, Institute of Medical Biometry & Medical Informatics and Pediatric Hematology & Oncology, Center for Pediatrics & Adolescent Medicine, University Medical Center Freiburg, Berliner Allee 29, Freiburg, Germany, 79110.
Joerg J
JJ
Meerpohl
Gerd
G
Antes
Gerta
G
Rücker
Nigel
N
Fleeman
Edith
E
Motschall
Charlotte M
CM
Niemeyer
Dirk
D
Bassler
D001565:Benzoates / Q000627:therapeutic use*; D015913:Chelation Therapy / Q000379:methods*; D000077588:Deferasirox; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy*; D009190:Myelodysplastic Syndromes / Q000150:complications*; D014230:Triazoles / Q000627:therapeutic use*
D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox