PMID- 24376563
OWN - NLM
STAT- MEDLINE
DCOM- 20150303
LR  - 20220409
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 12
DP  - 2013
TI  - Comparative efficacy and safety of deferoxamine, deferiprone and deferasirox on 
      severe thalassemia: a meta-analysis of 16 randomized controlled trials.
PG  - e82662
LID - 10.1371/journal.pone.0082662 [doi]
LID - e82662
AB  - OBJECTIVE: A meta-analysis was conducted to investigate the efficacy and safety 
      of three main iron chelators, namely, deferoxamine (DFO), deferiprone (DFP) and 
      deferasirox (DFX) for thalassemia major (TM) patients. METHODS: Randomized 
      controlled trials comparing mono-therapy DFO, DFP, DFX and combined DFP with DFO 
      therapy in TM patients from January 1990 to December 2012 were searched and 
      selected. Two independent authors assessed data from extracted randomized trials 
      for efficacy and safety in the measurements of serum ferritin (SF), live iron 
      concentration (LIC), myocardial iron content (MIC), left ventricular ejection 
      fraction (LVEF) and adverse events (AEs). RESULTS: Sixteen studies were selected. 
      In the comparison of DFP versus DFO treatment groups, a significant difference 
      was revealed on MIC and LVEF (P=0.01 and P=0.007, respectively) but not on SF or 
      LIC level (P=0.65 and P=0.37, respectively). In comparing combined therapy (DFP 
      plus DFO) versus DFO, a significant difference was shown on MIC and LVEF 
      measurements (P<0.00001 and P=0.003, respectively), but not on SF or LIC levels 
      (P=0.93 and P=0.62, respectively). Moreover, the combined DFP with DFO treatment 
      had significantly higher risk than DFO treatment (RR 1.46 with 95%CI 1.04 to 
      2.04). When comparing DFX with DFO, a significant difference was shown on the SF 
      level (P=0.003), and there was no difference between DFX and DFO in safety 
      evaluation (RR 1.53 with 95%CI 0.31 to 7.49). CONCLUSION: Findings indicated that 
      the most effective and safe iron chelators remains to be proven, and further 
      large-scale, long-term studies are needed.
FAU - Xia, Sujian
AU  - Xia S
AD  - Division of Medical Statistics, School of Medicine, University of Jinan, 
      Guangzhou City, Guangdong, China.
FAU - Zhang, Weidong
AU  - Zhang W
AD  - Novartis Pharmaceuticals Oncology, Beijing, China.
FAU - Huang, Liting
AU  - Huang L
AD  - Zhuhai People's Hospital, Zhuhai City, Guangdong, China.
FAU - Jiang, Hong
AU  - Jiang H
AD  - Division of Medical Statistics, School of Medicine, University of Jinan, 
      Guangzhou City, Guangdong, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20131223
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Benzoates)
RN  - 0 (Iron Chelating Agents)
RN  - 0 (Pyridones)
RN  - 0 (Triazoles)
RN  - 2BTY8KH53L (Deferiprone)
RN  - 9007-73-2 (Ferritins)
RN  - E1UOL152H7 (Iron)
RN  - J06Y7MXW4D (Deferoxamine)
RN  - V8G4MOF2V9 (Deferasirox)
SB  - IM
MH  - Benzoates/*adverse effects/*therapeutic use
MH  - Deferasirox
MH  - Deferiprone
MH  - Deferoxamine/*adverse effects/*therapeutic use
MH  - Ferritins/blood
MH  - Humans
MH  - Iron/metabolism
MH  - Iron Chelating Agents/adverse effects/therapeutic use
MH  - Liver/metabolism
MH  - Magnetic Resonance Imaging
MH  - Myocardium/metabolism
MH  - Pyridones/*adverse effects/*therapeutic use
MH  - *Randomized Controlled Trials as Topic
MH  - Stroke Volume
MH  - Thalassemia/blood/*drug therapy/physiopathology
MH  - Treatment Outcome
MH  - Triazoles/*adverse effects/*therapeutic use
PMC - PMC3871701
COIS- Competing Interests: The authors have the following interests. Weidong Zhang is 
      employed by Novartis Pharmaceuticals Oncology. There are no patents, products in 
      development or marketed products to declare. This does not alter the authors' 
      adherence to all the PLOS ONE policies on sharing data and materials, as detailed 
      online in the guide for authors. The other authors have no competing interest.
EDAT- 2014/01/01 06:00
MHDA- 2015/03/04 06:00
PMCR- 2013/12/23
CRDT- 2013/12/31 06:00
PHST- 2013/04/23 00:00 [received]
PHST- 2013/10/25 00:00 [accepted]
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2015/03/04 06:00 [medline]
PHST- 2013/12/23 00:00 [pmc-release]
AID - PONE-D-13-16818 [pii]
AID - 10.1371/journal.pone.0082662 [doi]
PST - epublish
SO  - PLoS One. 2013 Dec 23;8(12):e82662. doi: 10.1371/journal.pone.0082662. 
      eCollection 2013.