Abstract Background Myocardial iron overload is the leading cause of death in patients with beta-thalassemia major. Combined therapy with deferiprone(DFP) and desferrioxamine (DFO)were suggested to be more effective than deferasirox(DFX) for removing heart iron. Deferasirox has recently been made available, but its long-term efficacy on cardiac function has not yet been established. Our study aimed to compare the effectiveness of deferiprone and desferrioxamine with deferasiroxon ventricular function in thalassemia major patients. Materials and Methods In this clinical trial study,72 thalassemia major (TM) patients were randomised to receive either deferiprone combined with desferrioxamine and deferasirox ,and thencardiac functions were evaluated. Data were analysed for left ventricular ejection fractions(LVEF)at baselinebyechocardiograpy, following 12 months of treatment. Results 72 TM patientswere enrolled in this study lasting 12 months, 36 TMwere placed on DFP/DFO (DFP,50–86 mg/kg body weight DFO, 24–52 mg/kg body weigh), 36 received DFX (range 18–40 mg/kg body weight). In 36 patients receiving combined therapy, left ventricular ejection fraction increased from 59.3+/-5.7% to 63.7+/-5.1% (p=0.001) over 12 months [baseline LVEF values 56-61%]. Deferasirox showed no change in LVEF (p = 0.93).We found improvement of left ventricular ejection fractionsin the deferiprone combined with desferrioxamine versus the deferasirox group (P = 0.008). Conclusion The patients treated with combined therapy with deferiprone and desferrioxamine showed better systolic ventricular function compared to the patients treated with deferasirox. The patients treated with combined therapy with deferiprone and desferrioxamine showed better systolic ventricular function compared to the patients treated with deferasirox.

Keywords: beta- thalassemia, deferiprone, deferasirox

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