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Desferrioxamine mesylate for managing transfusional iron overload in people with transfusion-dependent thalassaemia

  1. Sheila A Fisher1,
  2. Susan J Brunskill1,
  3. Carolyn Doree1,
  4. Sarah Gooding2,
  5. Onima Chowdhury3,
  6. David J Roberts1,*

Editorial Group: Cochrane Cystic Fibrosis and Genetic Disorders Group

Published Online: 21 AUG 2013

Assessed as up-to-date: 14 AUG 2013

DOI: 10.1002/14651858.CD004450.pub3


How to Cite

Fisher SA, Brunskill SJ, Doree C, Gooding S, Chowdhury O, Roberts DJ. Desferrioxamine mesylate for managing transfusional iron overload in people with transfusion-dependent thalassaemia. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004450. DOI: 10.1002/14651858.CD004450.pub3.

Author Information

  1. 1

    NHS Blood and Transplant, Systematic Review Initiative, Oxford, Oxon, UK

  2. 2

    John Radcliffe and Churchill Hospital, Department of Haematology, Oxford, UK

  3. 3

    Weatherall Institute of Molecular Medicine, Haematopoietic Stem Cell Laboratory, Oxford, UK

*David J Roberts, Systematic Review Initiative, NHS Blood and Transplant, Level 2, John Radcliffe Hospital, Headington, Oxford, Oxon, OX3 9BQ, UK. david.roberts@ndcls.ox.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 AUG 2013

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[Figure 1]
Figure 1. PRISMA study flow diagram.
[Figure 2]
Figure 2. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 3]
Figure 3. Forest plot of comparison: 1 DFO alone versus deferiprone alone, outcome: 1.14 Adverse events.
[Figure 4]
Figure 4. Forest plot of comparison: 3 DFO alone versus DFO and deferiprone in combination, outcome: 3.11 Adverse events.
[Analysis 1.1]
Analysis 1.1. Comparison 1 DFO alone versus deferiprone alone, Outcome 1 Left ventricular ejection fraction: mean change from baseline (%).
[Analysis 1.2]
Analysis 1.2. Comparison 1 DFO alone versus deferiprone alone, Outcome 2 Right ventricular ejection fraction: mean at endpoint (%).
[Analysis 1.3]
Analysis 1.3. Comparison 1 DFO alone versus deferiprone alone, Outcome 3 Liver fibrosis Ishak score: mean at endpoint.
[Analysis 1.4]
Analysis 1.4. Comparison 1 DFO alone versus deferiprone alone, Outcome 4 Serum ferritin concentration: mean change from baseline (ng/ml).
[Analysis 1.5]
Analysis 1.5. Comparison 1 DFO alone versus deferiprone alone, Outcome 5 Urinary iron excretion: mean at endpoint (mg/24h).
[Analysis 1.6]
Analysis 1.6. Comparison 1 DFO alone versus deferiprone alone, Outcome 6 Urinary iron excretion: mean over study (%).
[Analysis 1.7]
Analysis 1.7. Comparison 1 DFO alone versus deferiprone alone, Outcome 7 Urinary iron excretion: mean change from baseline (mg/24h).
[Analysis 1.8]
Analysis 1.8. Comparison 1 DFO alone versus deferiprone alone, Outcome 8 Liver iron concentration: ratio of geometric means at endpoint (mg/g dry weight).
[Analysis 1.9]
Analysis 1.9. Comparison 1 DFO alone versus deferiprone alone, Outcome 9 Liver iron concentration: mean change from baseline (mg/g dry weight).
[Analysis 1.10]
Analysis 1.10. Comparison 1 DFO alone versus deferiprone alone, Outcome 10 Myocardial T2*: ratio of geometric means of change from baseline.
[Analysis 1.11]
Analysis 1.11. Comparison 1 DFO alone versus deferiprone alone, Outcome 11 Chelation efficiency (%).
[Analysis 1.12]
Analysis 1.12. Comparison 1 DFO alone versus deferiprone alone, Outcome 12 Plasma NTBI: mean change from baseline (mM).
[Analysis 1.13]
Analysis 1.13. Comparison 1 DFO alone versus deferiprone alone, Outcome 13 Total iron excretion: mean at endpoint (mg/kg/day).
[Analysis 1.14]
Analysis 1.14. Comparison 1 DFO alone versus deferiprone alone, Outcome 14 Adverse events.
[Analysis 1.15]
Analysis 1.15. Comparison 1 DFO alone versus deferiprone alone, Outcome 15 Participant compliance (%).
[Analysis 2.1]
Analysis 2.1. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 1 Left ventricular ejection fraction: mean at endpoint (%).
[Analysis 2.2]
Analysis 2.2. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 2 Serum ferritin concentration: mean at endpoint (ng/ml).
[Analysis 2.3]
Analysis 2.3. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 3 Serum ferritin concentration: mean change from baseline (ng/ml).
[Analysis 2.4]
Analysis 2.4. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 4 Urinary iron excretion: mean over study (%).
[Analysis 2.5]
Analysis 2.5. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 5 Urinary iron excretion: mean at endpoint (mg/24h).
[Analysis 2.6]
Analysis 2.6. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 6 Liver iron concentration: mean at endpoint (mg/g dry weight).
[Analysis 2.7]
Analysis 2.7. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 7 Chelation efficiency (%).
[Analysis 2.8]
Analysis 2.8. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 8 Plasma NTBI: mean change from baseline (mM).
[Analysis 2.9]
Analysis 2.9. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 9 Total Iron excretion: mean at endpoint (mg/kg/day).
[Analysis 2.10]
Analysis 2.10. Comparison 2 DFO and deferiprone in combination compared with deferiprone alone, Outcome 10 Adverse Events.
[Analysis 3.1]
Analysis 3.1. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 1 Left ventricular ejection fraction: mean at endpoint (%).
[Analysis 3.2]
Analysis 3.2. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 2 Serum ferritin concentration: ratio of geometric means at endpoint (ng/ml).
[Analysis 3.3]
Analysis 3.3. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 3 Serum ferritin concentration: ratio of geometric means at endpoint (ng/ml).
[Analysis 3.4]
Analysis 3.4. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 4 Serum ferritin concentration: mean change from baseline (ng/ml).
[Analysis 3.5]
Analysis 3.5. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 5 Urinary iron excretion: mean at endpoint (mg/24h).
[Analysis 3.6]
Analysis 3.6. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 6 Urinary iron excretion: mean over study (%).
[Analysis 3.7]
Analysis 3.7. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 7 Liver iron concentration: mean change from baseline.
[Analysis 3.8]
Analysis 3.8. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 8 Chelation efficency (%).
[Analysis 3.9]
Analysis 3.9. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 9 Plasma NBTI: mean change from baseline (mM).
[Analysis 3.10]
Analysis 3.10. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 10 Total iron excretion: mean at endpoint (mg/kg/day).
[Analysis 3.11]
Analysis 3.11. Comparison 3 DFO alone versus DFO and deferiprone in combination, Outcome 11 Adverse events.
[Analysis 4.1]
Analysis 4.1. Comparison 4 DFO compared with Deferasirox, Outcome 1 Serum ferritin concentration: mean change from baseline (ng/ml).
[Analysis 4.2]
Analysis 4.2. Comparison 4 DFO compared with Deferasirox, Outcome 2 Liver iron concentration: mean change from baseline (mg/g dry weight).
[Analysis 4.3]
Analysis 4.3. Comparison 4 DFO compared with Deferasirox, Outcome 3 Total iron excretion: ratio of iron excretion to iron intake (mg/kg/day).
[Analysis 5.1]
Analysis 5.1. Comparison 5 DFO schedule A (either method of administration or dose A) compared with DFO schedule B (either method of administration or dose B), Outcome 1 Serum ferritin concentration: mean at endpoint (ng/ml).
[Analysis 5.2]
Analysis 5.2. Comparison 5 DFO schedule A (either method of administration or dose A) compared with DFO schedule B (either method of administration or dose B), Outcome 2 Urinary iron excretion (mg/24h).
[Analysis 5.3]
Analysis 5.3. Comparison 5 DFO schedule A (either method of administration or dose A) compared with DFO schedule B (either method of administration or dose B), Outcome 3 Liver iron concentration: mean at endpoint (mg/g dry weight).