title: Iron chelation adherence to deferoxamine and deferasirox in thalassemia.
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.
authors.affiliation: New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA. ftrachtenberg@neriscience.com
authors.forename: Felicia
authors.initials: F
authors.lastname: Trachtenberg
authors.forename: Elliott
authors.initials: E
authors.lastname: Vichinsky
authors.forename: Dru
authors.initials: D
authors.lastname: Haines
authors.forename: Zahra
authors.initials: Z
authors.lastname: Pakbaz
authors.forename: Lauren
authors.initials: L
authors.lastname: Mednick
authors.forename: Amy
authors.initials: A
authors.lastname: Sobota
authors.forename: Janet
authors.initials: J
authors.lastname: Kwiatkowski
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Thompson
authors.forename: John
authors.initials: J
authors.lastname: Porter
authors.forename: Thomas
authors.initials: T
authors.lastname: Coates
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Giardina
authors.forename: Nancy
authors.initials: N
authors.lastname: Olivieri
authors.forename: Robert
authors.initials: R
authors.lastname: Yamashita
authors.forename: Ellis J
authors.initials: EJ
authors.lastname: Neufeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001565:Benzoates / Q000009:adverse effects / Q000627:therapeutic use*; D015913:Chelation Therapy / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D000077588:Deferasirox; D003676:Deferoxamine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008499:Medical Records; D055118:Medication Adherence; D008875:Middle Aged; D009656:North America; D012189:Retrospective Studies; D057566:Self Report; D013789:Thalassemia / Q000188:drug therapy*; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D006113:United Kingdom; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D003676:Deferoxamine; D000077588:Deferasirox