Comparison of Compliance, Convenience, Satisfaction and Life Disturbances among Transfusion Dependent Beta-Thalassemic Children On Iron Chelation Therapy: An Observational and Cross-Sectional Study

Abstract

Objective: The gold standard of iron chelation has been Deferoxamine based on its established efficacy in multiple studies. Deferiprone and Deferasirox may have better compliance and satisfaction in view of the oral route of administration. The present study was designed to compare the compliance and satisfaction level of Deferasirox versus Deferoxamine and Deferiprone in multi-transfused thalassemic children with iron overload.
Method: In this cross-sectional, observational study 55 patients of thalassemia major on iron chelation at Thalassemia Centre of a tertiary care hospital were enrolled. The compliance, convenience, satisfaction and life disturbances were compared among the three iron chelation.
Results: 20 patients each received Deferoxamine and Deferiprone whereas 15 received Deferasirox. The decrease in ferritin was comparable. Patients on Deferiprone and Deferasirox found it more convenient with less life disturbances than Deferoxamine (p<0.01, p<0.001). Both Deferiprone and Deferasirox did not show any significant difference in convenience and life disturbances. The three groups did not differ significantly in compliance and satisfaction level.
Conclusion: Considering the comparable efficacy of the three modalities and more convenience with Deferasirox and Deferiprone along with lesser life disturbances than DFO, the oral iron chelators can be used as a preferred choice as single use or in combination. Deferasirox may be the best option among all three in view of the convenience with once daily dosing, lesser life disturbances and no significant side effects.