Impact of Deferiprone vs. Deferoxamine on Right Heart Function in Thalassemia Patients
Author Information
Author(s): Gillian C. Smith, Francisco Alpendurada, John Paul Carpenter, Mohammed H. Alam, Vasili Berdoukas, Markissia Karagiorga, Vasili Ladis, Antonio Piga, Athanassios Aessopos, Efstathios D. Gotsis, Mark A. Tanner, Mark A. Westwood, Renzo Galanello, Michael Roughton, Dudley J. Pennell
Primary Institution: Royal Brompton & Harefield NHS Foundation Trust
Hypothesis
Deferiprone would improve RV function more than deferoxamine.
Conclusion
Deferiprone monotherapy was superior to deferoxamine for improving right ventricular function and volumes.
Supporting Evidence
- Deferiprone reduced RV end systolic volume from 37.7 to 34.2 mL.
- RV ejection fraction increased from 69.6% to 72.2% with deferiprone.
- Deferoxamine showed no significant change in RVESV or RVEF.
- Patients with lower baseline EF values showed greater improvement with deferiprone.
- Deferiprone showed a mean effect on RVESV of -1.82 mL compared to deferoxamine.
Takeaway
This study looked at two medicines for thalassemia patients and found that one medicine, deferiprone, worked better for the heart than the other.
Methodology
Patients were randomized to receive either deferiprone or deferoxamine, and cardiac function was assessed using CMR scans at baseline, 6 months, and 12 months.
Potential Biases
Local blinding to treatment was not possible due to the nature of drug administration.
Limitations
The study was a retrospective analysis and did not include RV long axis images for 3D volumetric analysis.
Participant Demographics
Patients were regularly transfused thalassemia major patients from 4 centers in Greece and Italy.
Statistical Information
P-Value
p = 0.008 for RV ESV, p = 0.001 for RVEF
Confidence Interval
95% CI 0.8 to 6.3%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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