Getting the iron out

From Philadelphia, at a meeting of the American Society of Hematology

While transfusions are lifesavers for many anemia patients, they introduce excess iron into recipients. This overload can damage the liver, pancreas, and heart. A new pill that reverses this process may vastly improve the lives of anemia patients, a new study shows.

The standard drug for removing iron from the body is deferoxamine mesylate. It chemically captures, or chelates, excess iron but must be given intravenously or by injection. The chief problem with deferoxamine mesylate therapy is that patients sometimes skip treatments, notes Stanley L. Schrier of Stanford University. A pill-based alternative would presumably be easier for patients to follow.

The new medication, now designated as ICL670, binds to excess iron, and these complexes ultimately leave the body in the feces. Researchers in Italy compared deferoxamine mesylate with ICL670 in 71 patients with an average age of 25. The participants had a hereditary form of anemia called thalassemia that required them to get transfusions every 3 weeks. They had been receiving deferoxamine mesylate via a needle drip placed under the skin for 8 hours a night, 5 nights a week.

Periodic testing of iron content in the patients’ blood and liver over a year showed that ICL670 cleared transfusion-caused iron overload as well as deferoxamine mesylate did, says study coauthor Antonio Piga of Turin University.

If the work is confirmed, ICL670 “would represent a major clinical advance for patients with sickle-cell [anemia]” and others who need regular blood transfusions, says Ronald Hoffman of the University of Illinois Medical Center in Chicago.


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