International Journal of Hematology

, Volume 93, Issue 3, pp 319–328 | Cite as

Clinical efficacy and safety evaluation of tailoring iron chelation practice in thalassaemia patients from Asia-Pacific: a subanalysis of the EPIC study of deferasirox

  • Vip Viprakasit
  • Hishamshah Ibrahim
  • Shau-Yin Ha
  • Phoebe Joy Ho
  • Chi-Kong Li
  • Lee-Lee Chan
  • Chang-Fang Chiu
  • Pranee Sutcharitchan
  • Dany Habr
  • Gabor Domokos
  • Bernard Roubert
  • Hong-Ling Xue
  • Donald K. Bowden
  • Kai-Hsin Lin
Original Article


Although thalassaemia is highly prevalent in the Asia-Pacific region, clinical data on efficacy and safety profiles of deferasirox in patients from this region are rather limited. Recently, data from the multicentre Evaluation of Patients’ Iron Chelation with Exjade (EPIC) study in 1744 patients with different anaemias has provided an opportunity to analyse 1115 thalassaemia patients, of whom 444 patients were from five countries in the Asia-Pacific region (AP) for whom thalassaemia management and choice of iron chelators were similar. Compared to the rest of the world (ROW), baseline clinical data showed that the AP group appeared to be more loaded with iron (3745.0 vs. 2822.0 ng/ml) and had a higher proportion on deferoxamine monotherapy prior to the study (82.9 vs. 58.9%). Using a starting deferasirox dose based on transfusional iron intake and tailoring it to individual patient response, clinical efficacy based on serum ferritin reduction in AP and ROW thalassaemia patients was similar. Interestingly, the AP group developed a higher incidence of drug-related skin rash compared to ROW (18.0 vs. 7.2%), which may indicate different pharmacogenetic backgrounds in the two populations. Our analysis confirms that, with appropriate adjustment of dose, deferasirox can be clinically effective across different regions, with manageable side effects.


Thalassaemia Iron chelation therapy Asia-Pacific Serum ferritin Skin rash 



The authors would like to thank Suresh Vutukuru for statistical support and Hui-Hwa Choo for medical editorial assistance with this manuscript. V.V. is supported by Thailand Research Fund & BIOTEC, Thailand. Novartis Pharma provided sponsorship for the EPIC study and financial support for medical editorial assistance of this manuscript.

Conflict of interest


Supplementary material

12185_2011_789_MOESM1_ESM.doc (85 kb)
Supplementary material 1 (DOC 85 kb)


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Copyright information

© The Japanese Society of Hematology 2011

Authors and Affiliations

  • Vip Viprakasit
    • 1
  • Hishamshah Ibrahim
    • 2
  • Shau-Yin Ha
    • 3
  • Phoebe Joy Ho
    • 4
  • Chi-Kong Li
    • 5
  • Lee-Lee Chan
    • 6
  • Chang-Fang Chiu
    • 7
  • Pranee Sutcharitchan
    • 8
  • Dany Habr
    • 9
  • Gabor Domokos
    • 10
  • Bernard Roubert
    • 10
  • Hong-Ling Xue
    • 11
  • Donald K. Bowden
    • 12
  • Kai-Hsin Lin
    • 13
  1. 1.Haematology-Oncology Division, Department of Paediatrics and Thalassaemia Center, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand
  2. 2.Hospital Kuala LumpurKuala LumpurMalaysia
  3. 3.Queen Mary Hospital, The University of Hong KongHong KongHong Kong
  4. 4.Royal Prince Alfred HospitalSydneyAustralia
  5. 5.Prince of Wales Hospital, Chinese University of Hong KongHong KongHong Kong
  6. 6.University Malaya Medical CentreKuala LumpurMalaysia
  7. 7.China Medical University HospitalTaichungTaiwan
  8. 8.Chulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand
  9. 9.Novartis Pharmaceuticals CorpEast HanoverUSA
  10. 10.Novartis Pharma AGBaselSwitzerland
  11. 11.Novartis Asia Pacific PharmaceuticalsSingaporeSingapore
  12. 12.Monash Medical CentreMelbourneAustralia
  13. 13.National Taiwan University HospitalTaipeiTaiwan

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