Ricchi Paolo, Marsella Maria
UOSD Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", Naples, Italy.
UOSD Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", Naples, Italy ; UOC Pediatria, Azienda Ospedaliera di Rilievo Nazionale G. Rummo, Benevento, Italy.
Drug Des Devel Ther. 2015 Dec 16;9:6475-82. doi: 10.2147/DDDT.S40694. eCollection 2015.
It has been clearly shown that iron overload adds progressively significant morbidity and mortality in patients with non-transfusion-dependent thalassemia (NTDT). The lack of physiological mechanisms to eliminate the excess of iron requires effective iron chelation therapy. The reduced compliance to deferoxamine and the risk of severe hematological adverse events during deferiprone treatment have limited the use of both these drugs to correct iron imbalance in NTDT. According to the principles of evidence-based medicine, following the demonstration of the effectiveness and the safety of deferasirox (Exjade(®)) in a prospective, randomized, controlled trial, deferasirox was approved by the US Food and Drug Administration in May 2013 for the treatment of iron overload associated with NTDT. This review, assessing the available scientific literature, will focus on the profile of DFX in the treatment of non-transfusional hemosiderosis in patients with NTDT.
已有明确证据表明,铁过载会使非输血依赖型地中海贫血(NTDT)患者的发病率和死亡率逐渐显著增加。由于缺乏消除过量铁的生理机制,需要有效的铁螯合疗法。去铁胺的依从性降低以及去铁酮治疗期间发生严重血液学不良事件的风险,限制了这两种药物在纠正NTDT中铁失衡方面的应用。根据循证医学原则,在一项前瞻性、随机、对照试验证明地拉罗司(Exjade®)的有效性和安全性之后,地拉罗司于201年5月获得美国食品药品监督管理局批准,用于治疗与NTDT相关的铁过载。本综述通过评估现有科学文献,将聚焦于地拉罗司在治疗NTDT患者非输血性含铁血黄素沉着症方面的情况。