Use of iron chelator therapy in Miri Hospital

Abstract

Introduction:

Globally, it’sestimated that more than 300 million people are Thalassemia trait carriers, with most of the population residing in South East Asia. Thalassemia is a heterogenous group of blood disorders which affects the production of haemoglobin resulting in decreased synthesis of α or β globin chains. The mainstay of treatment for thalassemia is regular blood transfusion. However, regular blood transfusions often lead to iron overload. Hence, iron chelating agents employed to remove excess iron in transfusion‐dependent β-thalassaemia patients. The aim of this study is to analyse the prescribing trend and cost-effectiveness between iron chelators (Deferiprone, Deferoxamine, and Deferasirox) as well to evaluate the treatment efficacy between the iron chelators in reducing serum ferritin levels.

Methods: The analysis examined usage of iron chelators (Deferiprone, Deferoxamine, and Deferasirox) available in Miri Hospital from January 2016 until December 2017 to establish the prescribing trend of iron chelators in Miri Hospital. Information regarding the number of prescriptions, packs and cost of the drugs obtained through Pharmacy Information System (PhIS). A patient level analysis obtained through PhIS used to examine the age, race and sex of the patients.

Results: Majority of the β-thalassemia patients on iron chelator therapy in Miri Hospital were Malay (64%), followed by Chinese which constituted 27% while the other races comprise another 9% of the patient base. Based on the data collected across both years (2016-2017), generally the iron chelator most commonly prescribed was Deferasirox (DFX), followed by Deferiprone (DFP) and lastly Deferoxamine (DFO).

Conclusion:

Effective chelation therapy attained when iron chelators remove enough excess iron, equivalent to that accumulated in the body from transfusion. Hence, due to its high chelation efficacy and patient-friendly dosing regime, DFX remains the highest prescribed oral iron chelator in Miri Hospital.