Comparing the efficacy of Dexeroyx (Osveral) and Deferoxamine (Desferal) in reducing serum ferritin level in patients with thalassemia major

Abstract

Background: Considering the necessity of permanent use of iron chelating agents in patients with thalassemia and the difficulty of using injectable drugs such as desferal, has given a special place to research on oral alternatives. The aim of the present study was to introduce oral Dexeroyx as an alternative to injectable desferal and also to determine its efficacy to reduce serum level of ferritin in patients with thalassemia. Methods: This cross-over clinical trial was performed on 51 thalassemia patients randomly divided into two groups receiving desferal (50mg /kg / day intravenously) or Dexeroyx (20mg /kg /day orally). Serum ferritin levels were determined in both groups before treatment and then they were treated for 6 months and serum ferritin levels were determined on a monthly basis. After this period, with a one-month washout period, the treatment plan was transferred to the two groups. Results: In the first phase of the study, although a downward trend in the level of ferritin was revealed in both groups within six months of interventions, no difference was found across the two groups. Similar findings were observed in the second phase of intervention so that in both groups receiving desferal or Dexeroyx, the serum level of ferritin gradually decreased within the six months of treatment, but no difference was found between the two groups in the trend of the change in ferritin level. The serum level of ferritin was independent to some baseline factors including gender, age, or history of splenectomy. Conclusion: Dexeroyx is at least as effective as desferal in reducing serum ferritin levels. If there is no contraindication for using oral medications, Dexeroyx can be prescribed as an appropriate alternative for desferal in thalassemia patients.