Clinical application of deferasirox: practical patient management

Deferasirox (Exjade, ICL670) is a once-daily, oral iron chelation agent that is now widely available for the treatment of transfusional hemosiderosis in adult and pediatric patients aged > or =2 years of age. Clinical evaluation has established the efficacy and safety of this novel agent in patients with a variety of chronic anemias. Deferasirox represents a significant advance in the treatment of iron overload, as the availability of an effective oral therapy has the potential to relieve many patients from the burden of frequent parenteral therapy with the previous reference standard iron chelator, deferoxamine. The most common drug-related adverse events seen in the core registration trials were gastrointestinal disturbances, rash, mild and nonprogressive increases in serum creatinine levels, and elevations in liver enzyme levels. Most events were transient, mild-to-moderate in severity, and easily managed without discontinuation of treatment. As with any new agent, it is important that treating physicians are familiar with the adverse event profile of deferasirox and how the associated effects can be readily managed to ensure optimal use of this important treatment.