Deferasirox效果好吗？

Three iron-chelating drugs are currently approved to reduce iron burden, including ferroxamine, ferriproxine, and deferasirox (). Deferrioxamine (DFO) can combine with iron in ferritin or hemosiderin, convert it into ferrioxamine molecules and be excreted by the kidneys. The production of ferrioxamine can prevent the chemical reaction of iron, thereby reducing the formation of reactive oxygen species. Desferrioxamine can be injected subcutaneously or intravenously, and the dosage is 20~60mg/kg. Since the half-life is only 20 minutes, it requires continuous administration for a long time, which is more inconvenient. Both ferriprone and deferasirox can chelate intracellular iron and more directly remove iron that generates ROS than ferroxamine. Ordroferrione is an oral drug with a half-life of 2 to 3 hours. The dose is 50 to 100 mg/kg per day, taken orally in 3 times. It has many gastrointestinal side effects. The daily dosage of deferasirox dispersible tablets is 20~30 mg/kg, once a day, and has good clinical compliance, but it is expensive. In addition to chelating intracellular iron, deferasirox is also related to the increase in hepcidin, which can reduce iron absorption in intestinal cells, so the iron removal effect is better. 

According to a retrospective study in Italy, 42.7% of patients achieved a hematological response and reduced the need for blood transfusions after receiving DFO or deferasirox chelation therapy. There may be a dynamic, bidirectional regulatory mechanism between erythropoiesis and iron overload. On the one hand, ineffective erythropoiesis can lead to increased intestinal iron absorption through reduced hepcidin secretion by the liver. On the other hand, chelation treatment of iron overload can improve erythropoiesis, increase hemoglobin levels, and reduce clinical blood transfusions.

Deferasirox dispersible tablets are oral medicines that are convenient to take once a day. Adverse reactions are mainly gastrointestinal reactions, rashes, liver and kidney damage, etc. However, the incidence of these is not high. Even if they occur, they can generally be alleviated by adjusting the drug dosage and taking method. However, the disadvantage of deferasirox is that it is relatively expensive and is not included in the medical insurance reimbursement list. However, a generic version of deferasirox has now been launched in India. This drug is produced by cipla in India. Its efficacy is the same as deferasirox, but the price is much cheaper. It is very suitable for patients who pursue a higher quality of life. However, the drug is not marketed in the country. If necessary, please consult Medical Companion Travel for purchasing methods.