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地拉罗司可降低非输血依赖型地中海贫血患者肝铁浓度,且呈剂量依赖性,在各亚组患者中均有一致的疗效。

Deferasirox demonstrates a dose-dependent reduction in liver iron concentration and consistent efficacy across subgroups of non-transfusion-dependent thalassemia patients.

机构信息

Hematology and Oncology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.

出版信息

Am J Hematol. 2013 Jun;88(6):503-6. doi: 10.1002/ajh.23445. Epub 2013 May 13.

DOI:10.1002/ajh.23445
PMID:23553596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3698696/
Abstract

The 1-year THALASSA study enrolled 166 patients with various non-transfusion-dependent thalassemia (NTDT) syndromes, degrees of iron burden and patient characteristics, and demonstrated the overall efficacy and safety of deferasirox in reducing liver iron concentration (LIC) in these patients. Here, reduction in LIC with deferasirox 5 and 10 mg/kg/day starting dose groups is shown to be consistent across the following patient subgroups-baseline LIC/serum ferritin, age, gender, race, splenectomy (yes/no), and underlying NTDT syndrome (β-thalassemia intermedia, HbE/β-thalassemia or α-thalassemia). These analyses also evaluated deferasirox dosing strategies for patients with NTDT. Greater reductions in LIC were achieved in patients dose-escalated at Week 24 from deferasirox 10 mg/kg/day starting dose to 20 mg/kg/day. Patients who received an average actual dose of deferasirox >12.5-≤17.5 mg/kg/day achieved a greater LIC decrease compared with the ≥7.5-≤12.5 mg/kg/day and >0-<7.5 mg/kg/day subgroups, demonstrating a dose-response efficacy. LIC reduction across patient subgroups was generally consistent with the primary efficacy analysis with a similar safety profile.

摘要

为期 1 年的 THALASSA 研究纳入了 166 例患有各种非输血依赖型地中海贫血(NTDT)综合征、不同铁负荷程度和患者特征的患者,证实了地拉罗司降低这些患者肝铁浓度(LIC)的总体疗效和安全性。在此,地拉罗司 5 毫克/公斤/天和 10 毫克/公斤/天起始剂量组降低 LIC 的结果在以下患者亚组中是一致的-基线 LIC/血清铁蛋白、年龄、性别、种族、脾切除术(有/无)和基础 NTDT 综合征(中间型β地中海贫血、HbE/β地中海贫血或α地中海贫血)。这些分析还评估了地拉罗司在 NTDT 患者中的给药策略。从地拉罗司 10 毫克/公斤/天起始剂量增加到 20 毫克/公斤/天,在第 24 周进行剂量调整的患者中,LIC 降低幅度更大。实际平均地拉罗司剂量>12.5-≤17.5 毫克/公斤/天的患者与≥7.5-≤12.5 毫克/公斤/天和>0-<7.5 毫克/公斤/天亚组相比,LIC 降低幅度更大,显示出剂量反应疗效。患者亚组之间的 LIC 降低与主要疗效分析基本一致,安全性特征相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307d/3698696/85ae854ff63b/ajh0088-0503-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307d/3698696/5780f3305748/ajh0088-0503-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307d/3698696/85ae854ff63b/ajh0088-0503-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307d/3698696/5780f3305748/ajh0088-0503-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307d/3698696/85ae854ff63b/ajh0088-0503-f2.jpg

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Ascorbate status modulates reticuloendothelial iron stores and response to deferasirox iron chelation in ascorbate-deficient rats.抗坏血酸状态调节网状内皮细胞铁储存和去铁酮螯合铁治疗在抗坏血酸缺乏大鼠中的反应。
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