Comparison of Therapeutic Response and Complications of Oral Osveral and Injection Desfereal Chelating Agent in Patient with Thalassemia Major

Iron overload is frequently leads to excessive iron deposition observed in patients with thalassemia because they receive frequent blood transfusion. Deferasirox, new oral iron chelators reduce iron load in transfusion-dependent patients. This study was performed to compare the efficacy and side effects of Desfereal versus Osveral in treatment of iron overload in transfusion patients with β-Thalassemia and intermediate thalassemia in Bandarabbas. Method: This clinical trial study performed on one hundred and thirty eight (above of two years) with β-Thalassemia and intermediate Thalassemia in Bandar Abbas. Patients were assigned randomly in two groups (69 cases in Osveral group and 69 cases in deferral group). Complete blood count, serum levels of Alanine aminotransferase (ALT), aspartate aminotransferase (AST), ferritin and creatinine were measured in both groups. First group receive 20 mg/kg oral Osveral daily and second group receive 40 mg/kg subcutaneous Desfereal per 12 hours. Complete blood count, serum levels of ALT, AST, ferritin and creatinine were measured in both groups. The cases reevaluated after 4 and 8 months. The date was analyzed by SPSS version 16 software using descriptive, Chi-square test and T-test. Significant level was set as P<0.005. Results: A total of 138 transfusion dependent patients received Osveral (n=69) or Desfereal (n=69). Decrease serum level of ferritin and hemoglobin there was significantly but this difference no significant in both groups. Abnormal laboratory studies with Osveral were associated with mild leukopenia (4.3%) and thrombocytopenia (5.8%) and with Desfereal were associated thrombocytopenia (1.4%). Conclusion: In this study transfusion dependent patient with thalassemia we observed a significant decrease in serum ferritin and hemoglobin with oral Osveral and Desfereal. Osveral is an oral iron chelator has acceptable tolerability and appears to have similar effects to Desfereal in decreasing serum iron in patients with iron overload. More randomized studies should be undertaken to determine the effects and side effects of iron chelators for treatment of iron overload.