DFX

• DFX has been studied in hundreds of patients with transfusional IOL, including MDS^1-4.
  • For patients with ongoing iron loading, a DFX dose of 20 mg/kg/day by mouth (DF, Exjade^®), appears sufficient to maintain iron levels, while often 30 mg/kg/day is required to achieve reduction in iron stores, depending on RBC transfusion requirements.
  • The most common AEs are GI symptoms (abdominal pain, nausea & vomiting, diarrhea & constipation,15.2%) & skin rash (10.8%)^2,3,5.
  • Dose-dependent increases in serum creatinine, usually reversible, were seen in one-third of patients. Postmarketing surveillance, however, identified several instances of fatal renal failure and cytopenias following institution of DFX. Regular follow-up of renal function and blood counts is recommended with weekly determinations for ≥the first 4 weeks of treatment & following dose increases.
  • Rare AEs include elevated ALT (0.6%), deafness (0.3%) & cataracts (0.3%).
  • The DFX FCT (Jadenu^®) appears to have fewer GI side effects, however, renal & other side effects appear to be similar to the DF6.
  • Doses must be adjusted down by 30% for patients receiving Jadenu^® rather than Exjade^®, due to better GI absorption & bioavailability^*.