Abstract
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.
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Acknowledgments
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.
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Appendix: Participating centres and investigators of the analysis
Appendix: Participating centres and investigators of the analysis
1.1 AP group
B. Augustson, Sir Charles Gairdner Hospital, Perth, Australia; A. Baba, Hospital University Sains Malaysia, Kota Bahru, Malaysia; D.K. Bowden, Monash Medical Centre, Melbourne, Australia; L-L Chan, University Malaya Medical Centre, Kuala Lumpur, Malaysia; S. Chancahrunee, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; P. Charoenkwan, Chiang Mai University, Chiang Mai, Thailand; C.-F. Chiu, China Medical University Hospital, Taichung, Taiwan; A. Chuansumrit, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; A. Grigg, Royal Melbourne Hospital, Melbourne, Australia; S.-Y. Ha, Queen Mary Hospital, The University of Hong Kong, Hong Kong; P.J. Ho, Royal Prince Alfred Hospital, Sydney, Australia; H.-C. Hsu, Taipei Veterans General Hospital, Taipei, Taiwan; H. Ibrahim, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; A.J. Mohamed Thalha, Hospital University Kebangsaan, Kuala Lumpur, Malaysia; S.-H. Lee, Royal Adelaide Hospital, Adelaide, Australia; C.-K. Li, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong; K.-H. Lin, National Taiwan University Hospital, Taipei, Taiwan; P. Sutcharitchan, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand; K. Taylor, Mater Hospital, Brisbane, Australia; V. Viprakasit, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
1.2 ROW group
The remaining participating centres and investigators of the EPIC study thalassaemia cohort from Austria, Belgium, China, Denmark, Egypt, France, Germany, Greece, Israel, Italy, Lebanon, South Africa, Spain, Switzerland, The Netherlands, Turkey and the United Kingdom have been reported previously [22].
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Viprakasit, V., Ibrahim, H., Ha, SY. et al. Clinical efficacy and safety evaluation of tailoring iron chelation practice in thalassaemia patients from Asia-Pacific: a subanalysis of the EPIC study of deferasirox. Int J Hematol 93, 319–328 (2011). https://doi.org/10.1007/s12185-011-0789-8
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DOI: https://doi.org/10.1007/s12185-011-0789-8