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Blood, 1 May 2006, Vol. 107, No. 9, pp. 3455-3462.
Prepublished online as a Blood First Edition Paper on December 13, 2005December 15, 2005; DOI 10.1182/blood-2005-08-3430.


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Submitted August 24, 2005
Accepted November 29, 2005

A Phase III study of deferasirox (ICL670), a once-daily oral iron chelator, in patients with {beta}-thalassemia

Maria D Cappellini*, Alan Cohen, Antonio Piga, Mohamed Bejaoui, Silverio Perrotta, Leyla Agaoglu, Yesim Aydinok, Antonis Kattamis, Yurdanur Kilinc, John Porter, Marcello Capra, Renzo Galanello, Slaheddine Fattoum, Guillermo Drelichman, Carmelo Magnano, Monica Verissimo, Miranda Athanassiou-Metaxa, Patricia Giardina, Alexandra Kourakli-Symeonidis, Gritta Janka-Schaub, Thomas Coates, Christiane Vermylen, Nancy Olivieri, Isabelle Thuret, Herbert Opitz, Catherine Ressayre-Djaffer, Peter Marks, and Daniele Alberti

Universita di Milano, Fondazione Policlinico IRCCS, Milan, Italy
Children's Hospital of Philadelphia, Philadelphia, PA, USA
Ospedale Regina Margherita, Turin, Italy
Centre National des Greffes de la Moelle Osseuse, Tunis, Tunisia
I Policlinico II Universita di Napoli, Naples, Italy
Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
Ege University Medical Faculty, Izmir, Turkey
First Department of Pediatrics, University of Athens, Athens, Greece
Cukurova University Medical Faculty, Adana, Turkey
University College Hospital, London, United Kingdom
Ospedale Civico e Benefratelli G. Di Cristina M. Ascoli, Palermo, Italy
Ospedale Regionale Microcitemie, Cagliari, Italy
Hospital d'Enfants, Tunis, Tunisia
Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina
Az. Ospedale di Riliervo Nazionale e di Alta Spec. Garibaldi, Catania, Italy
Centro Infantil de Investigacoes Hematologicas Dr. Boldrini, Campinas, Brazil
"Hippokration" General Hospital of Thessaloniki, Thessaloniki, Greece
New York Presbyterian Hospital, New York, NY, USA
University Hospital of Patras, Patras, Greece
Universitaetskrankenhaus Eppendorf, Hamburg, Germany
Children's Hospital of Los Angeles, Los Angeles, CA, USA
Cliniques Universtaires St. Luc, Brussels, Belgium
Toronto General Hospital, Toronto, Canada
Hopital de la Timone Enfants, Marseille, France
Novartis Pharma AG, Basel, Switzerland

* Corresponding author; email: maria.cappellini{at}unimi.it.

Deferasirox (ICL670) is a once-daily oral iron chelator developed for the treatment of chronic iron overload from blood transfusions. A comparative Phase III trial was conducted to demonstrate the efficacy of deferasirox in regularly transfused patients with {beta}-thalassemia ≥2 years of age. Patients were randomized and received treatment with deferasirox (n=296) or deferoxamine (n=290) with dosing of each according to baseline liver iron concentration (LIC). The primary endpoint was maintenance or reduction of LIC; secondary endpoints included safety and tolerability, change in serum ferritin level and net body iron balance. In both arms, patients with LIC values ≥7 mg Fe/g dry weight (dw) had significant and similar dose-dependent reductions in LIC and serum ferritin, and effects on net body iron balance. However, the primary endpoint was not met in the overall population, possibly due to the fact that proportionally lower doses of deferasirox relative to deferoxamine were administered to patients with LIC values < 7 mg Fe/g dw. The most common adverse events included rash, gastrointestinal disturbances, and mild non-progressive increases in serum creatinine. No agranulocytosis, arthropathy or growth failure was associated with deferasirox administration. Deferasirox is a promising once-daily oral therapy for the treatment of transfusional iron overload.


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