Comparison of effects of oral deferiprone and subcutaneous desferrioxamine on myocardial iron concentrations and ventricular function in beta-thalassaemia 

Authors
Lisa J. Anderson, Beatrix Wonke, Emma Prescott, Sally Holden, J. Malcolm Walker, Dudley J. Pennell

Journal
The Lancet, 2002, Volume 360, No. 9332, pages 516-520

Background
Based on data from the UK registry more than 50% of patients with thalassaemia major die before the age of 35 years, predominantly from iron-induced heart failure. The efficacy of oral deferiprone in reducing myocardial iron concentrations is unknown. The objective of this study was to compare the effects of deferiprone and deferoxamine on myocardial iron concentrations and ventricular function in beta-thalassaemia.

Methods

• Retrospective analysis of myocardial iron content and cardiac function were compared in 15 patients receiving long-term deferiprone treatment (mean duration 5.7 years) with 30 matched thalassaemia major controls who were on long-term treatment with deferoxamine.
• Myocardial iron concentrations were measured by a new magnetic resonance technique T2 star (T2*).
• Ventricular volumes, mass, and ejection fraction were measured by standard cardiovascular magnetic-resonance techniques.

Results – deferiprone-treated patients had significantly less myocardial iron than the deferoxamine-treated patients.

Results from the study indicate significantly lower myocardial iron content and a lower proportion of patients with excess myocardial iron in the deferiprone group than in the deferoxamine controls.



Results – deferiprone-treated patients had improved cardiac function.

Patients in the deferiprone-treated group had a better left-ventricular ejection fraction than patients in the deferoxamine group.



Conclusions
These results show that thalassaemia major patients on long-term treatment with deferiprone have lower myocardial iron concentration and improved cardiac function than a matched control group of patients on desferrioxamine. A larger prospective clinical trial is needed to confirm these results.

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