Comparison of deferasirox and deferoxamine treatment in iron-overloaded patients: liver iron concentration determined by quantitative MRI-R2*

Abstract

Objective To explore the value of MRI-R2*and to compare clinical effect of two iron chelators (deferasirox and deferoxamine) in iron-overloaded patients. Methods By completely randomized balanced design,24 iron-overloaded patients were randomly divided into 2 groups,which consisted of 12 patients treated with deferasirox and 12 patients treated with deferoxamine.The planned deferasirox dose was 40 mg·kg-1·d-1,and the deferoxamine dose was no less than 50 mg·kg-1·d-1.All patients underwent quantitative MRI at the time points of the primary screening,6 months and 12 months.Pair Wilcoxon rank sum test was used to compare the differences of liver R2*values of the 2 groups at various time points respectively.Wilcoxon rank sum test was used to compare the differences of change rate of liver R2*values between the two groups at the time point of 6 months,12 months,respectively. Results Deferasirox group's liver R2*values of primary screening,6 months and 12 months were 1081,889 and 712 Hz,while deferoxamine group's liver R2*values were 1042,838 and 488 Hz.There was no statistically significant difference between liver R2*values of two groups at primary screening (Z=-0.029,P>0.05).The change rate of liver R2*of deferasirox group at 12 month was-32%,while it was-58% for the deferoxamine group,and there was statistically significant difference between the two groups (Z=-3.060,P<0.01).The change rate of serum ferritin of deferasirox group at 12 month was-15%,while it was-55% for the deferoxamine group,and there was statistically significant difference between the two groups (Z=-2.945,P<0.01). Conclusion By using MRI-R2*,it suggest that both deferasirox and deferoxamine can effectively remove liver iron and deferoxamine is superior to deferasirox. Key words: Magnetic resonance imaging; Treatment outcome; Comparative study