title: Iranian experience of deferasirox (Exjade(®)) in transfusion-dependent patients with iron overload: what is the most effective dose based on serum ferritin levels?
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy and safety of deferasirox in patients from Iran.
  
  
  METHODS
  This was a retrospective, observational study in regularly transfused, iron-overloaded patients who received deferasirox 20-38 mg/kg/day  for up to 12 months. Changes in serum ferritin were assessed as follows: from baseline to 3 months with deferasirox doses of 20-24 mg/kg/day; from 3 to 6 months with doses of 25-29 mg/kg/day; and from 6 to 12 months with doses of 30-38 mg/kg/day. The safety  of deferasirox was evaluated monthly. Patients' satisfaction with treatment was assessed after 9 months.
  
  
  RESULTS
  One hundred and nineteen patients were included. Overall mean serum ferritin levels were significantly decreased from baseline after 12 months of deferasirox  therapy (2510 ± 1210 to 1665 ± 1240 ng/ml; P < 0.002). A significant decrease was observed once doses were increased to ≥30 mg/kg/day (P = 0.0003). Most adverse events were mild and observed at the dose of  20-24 mg/kg. Only one patient discontinued treatment. Around 90% of patients were satisfied with therapy.
  
  
  CONCLUSIONS
  This is the first study evaluating deferasirox in heavily iron-overloaded patients from Iran and confirms that deferasirox is effective and well  tolerated; however, dose increases to ≥30 mg/kg/day should be considered if efficacy is insufficient.
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. karimim@sums.ac.ir
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
authors.forename: Azita
authors.initials: A
authors.lastname: Azarkeivan
authors.forename: Soheila
authors.initials: S
authors.lastname: Zareifar
authors.forename: Nader
authors.initials: N
authors.lastname: Cohan
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Bordbar
authors.forename: Sezaneh
authors.initials: S
authors.lastname: Haghpanah
mesh_terms: D000293:Adolescent; D000328:Adult; D001565:Benzoates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000077588:Deferasirox; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019190:Iron Overload / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D065227:Transfusion Reaction; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D000077588:Deferasirox