About Iron Toxicity: Screening And Monitoring

About Iron Toxicity: Screening And Monitoring | EXJADE® (Deferasirox)

MENUEfficacy - IntroductionEfficacy - Chelation at Essential SitesEfficacy - Dose-Dependent ChelationEfficacy - Long-Term EfficacyEfficacy - 24-Hour Activity Efficacy - Clinical Trial SummariesSafety - Long-Term Safety ProfileSafety - Side Effect ManagementSafety - Monitoring GuidelinesSafety - Important Safety InformationDosing - Dosing GuidelinesDosing - Dose CalculatorDosing - Serum Ferritin TrackerPatient Types - IntroductionPatient Types - beta-ThalassemiaPatient Types - Myelodysplastic SyndromesPatient Types - Sickle Cell DiseasePatient Types - Other AnemiasPatient Types - IPSS CalculatorCompliance Support - IntroductionCompliance Support - Side Effect ManagementCompliance Support - Educational ToolsExjade Resources - Summary of Resources and ToolsExjade Resources - Related LinksExjade Resources - Mechanism of ActionAbout Iron Toxicity - Iron ToxicityAbout Iron Toxicity - Morbidity and MortalityAbout Iron Toxicity - Screening and MonitoringAbout Iron Toxicity - Managing Iron ToxicityExjade FAQsAbout Novartis OncologyContact UsSite MapTerms of UsePrivacy PolicyCountry Sites - CanadaCountry Sites - GermanyCountry Sites - JapanCountry Sites - NetherlandsCountry Sites - SwitzerlandCountry Sites - United StatesSwiss PIEU SmPCNovartis OncologyPubmedAre You An Exjade Prescriber Seeking Tips For Treatment Success?Are You Considering Exjade And Seeking Compelling Data?Are You A Researcher Seeking Exjade Information Resources?Swiss Prescribing InformationEU SmPCExjade Important Safety Information EXJADE is indicated for the treatment of chronic iron overload due to blood transfusions (transfusional hemosiderosis) in adult and pediatric patients (aged 2 years and over). Please click here for Swiss Prescribing Information. Please click here for EU SmPC. Please click here for Exjade Important Safety Information.References: 1. Cappellini MD, Cohen A, Piga A, et al. A phase 3 study of deferasirox (ICL670), a once-daily oral iron chelator, in patients with beta-thalassemia. Blood. 2006;107(9):3455-3462. 2. Eleftheriou P, Tanner M, Pennel D, Porter JB. Response of myocardial T2* to oral deferasirox monotherapy for 1 year in 29 patients with transfusion-dependent anaemias; a subgroup analysis [11th Congress of the European Hematology Association abstract 0999]. Haematologica. 2006;91(s1):366. 3. Wood J, Thompson AA, Paley C, et al. ExjadeŽ reduces cardiac iron burden in chronically transfused beta-thalassemia patients: an MRI T2* study [American Society of Hematology 49th Annual Meeting abstract 2781]. Blood. 2007;110(11):817a. 4. EXJADE Swiss prescribing information. Berne, Switzerland: Novartis Pharma Schweiz Inc; 2008. Disclaimer: This is an international website for EXJADE, and is intended for healthcare professionals outside the U.S. If you are a U.S. resident, please click on the U.S. residents link at the top of this page. The information on this site is not country-specific, and may contain information that is outside the approved indications in the country in which you are located.Š 2008 Novartis AG. Use of this website is subject to our Terms of Use. Screening and monitoring for iron toxicity is essential in transfusion-dependent patients
Since iron toxicity is a silent disease, rarely producing noticeable symptoms until serious end-organ damage has occurred, ongoing screening and monitoring for iron toxicity should be routinely performed for transfusion-dependent patients.Following are 2 methods to uncover iron toxicity. Serum ferritin test
Serum ferritin is a well-established blood test for iron toxicity that is relatively easy to perform. If serum ferritin is >1000 ľg/L, patients should initiate chelation therapy. In patients diagnosed with iron toxicity, serum ferritin levels should be monitored at least every 3 months.1,2
Although the accuracy of single measurements may be confounded by inflammation, multiple measurements over time provide a useful marker of trends in total body iron stores.2
Decreases in serum ferritin have been shown to correlate with dose-related decreases in liver iron concentration (assessed by biopsy).3
Liver iron concentration (LIC)
Because the liver is the primary storage site for iron, LIC is the reference standard method for measuring total body iron. It is also the most validated predictor of the risks a particular patient faces from the potential complications of iron toxicity. Elevated LIC has similar clinical significance across different underlying disorders.1,4

LIC values >7 mg Fe/g of dry weight are associated with increased morbidity5

LIC values >15 mg Fe/g of dry weight are associated with a substantially increased mortality risk5

Due to the invasiveness of liver biopsy, LIC is not commonly used to screen for iron toxicity. More widespread availability of noninvasive LIC tests, such as biomagnetic susceptometry and R2 MRI, may lead to greater usage of LIC as a screening test for iron toxicity.