Iron Chelation Adherence to Deferoxamine and Deferasirox in Thalassemia

被引:54
作者
Trachtenberg, Felicia [1 ]
Vichinsky, Elliott [2 ]
Haines, Dru [2 ]
Pakbaz, Zahra [2 ]
Mednick, Lauren [3 ]
Sobota, Amy [3 ]
Kwiatkowski, Janet [4 ]
Thompson, Alexis A. [5 ]
Porter, John [6 ]
Coates, Thomas [7 ]
Giardina, Patricia J. [8 ]
Olivieri, Nancy [9 ]
Yamashita, Robert [10 ]
Neufeld, Ellis J. [3 ]
机构
[1] New England Res Inst, Watertown, MA 02472 USA
[2] Childrens Hosp & Res Ctr Oakland, Dept Hematol Oncol, Oakland, CA USA
[3] Childrens Hosp Boston, Dept Hematol Oncol, Boston, MA USA
[4] Childrens Hosp Philadelphia, Dept Hematol, Philadelphia, PA USA
[5] Mem Hosp, Dept Hematol, Chicago, IL USA
[6] UCL, Inst Canc, London WC1E 6BT, England
[7] Childrens Hosp Los Angeles, Dept Hematol, Los Angeles, CA USA
[8] Cornell Univ, Weill Cornell Med Coll, Dept Hematol Oncol, New York, NY 10021 USA
[9] Toronto Gen Hosp, Univ Hlth Network, Toronto, ON, Canada
[10] Calif State Univ, Dept Liberal Studies, San Marcos, CA USA
关键词
THERAPY; IMPACT;
D O I
10.1002/ajh.21993
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The Thalassemia Clinical Research Network collected adherence information from 79 patients on deferoxamine and 186 on deferasirox from 2007 to 2009. Chelation adherence was defined as percent of doses administered in the last 4 weeks (patient report) out of those prescribed (chart review). Chelation history since 2002 was available for 97 patients currently on deferoxamine and 217 on deferasirox, with crude estimates of adherence from chart review. Self-reported adherence to both deferoxamine and deferasirox were quite high, with slightly higher adherence to the oral chelator (97 vs. 92%). Ninety percent of patients on deferasirox reported at least 90% adherence, compared with 75% of patients on deferoxamine. Adherence to both chelators was highest in children, followed by adolescents and older adults. Predictors of lower deferoxamine adherence were smoking in the past year, problems sticking themselves (adults only), problems wearing their pump, and fewer transfusions in the past year. Predictors of lower deferasirox adherence were bodily pain and depression. Switching chelators resulted in increased adherence, regardless of the direction of the switch, although switching from deferoxamine to deferasirox was far more common. As adherence to deferoxamine is higher than previously reported, it appears beneficial for patients to have a choice in chelators.
引用
收藏
页码:433 / 436
页数:4
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