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Background: Deferasirox (DFX) is a once-daily oral iron chelator with proven dose-dependent efficacy in patients with thalassemia major (TM). The reason for switching from DFX dispersible tablets (Exjade®) to DFX film-coated tablets (Jadenu®) was intolerance. Many patients also reported that deferasirox® did not taste good. In this study, we compared the effect of Jadenu® and Exjade® on satisfaction, convenience, cardiac/liver MRI T2*, serum ferritin levels, and biochemical profiles in patients with thalassemia major. Method: Sixty-two patients with thalassemia over 2 years of age, who had iron overload indicated by chelation therapy, were randomly divided into two groups. The first group (n = 32) is treated with Exjade®, and the second group (n = 30) is treated with Jadenu®. Laboratory investigations included alkaline phosphatase (ALK), alanine transferase (ALT), aspartate transferase (AST), and serum ferritin levels. Cardiac/liver MRI T2* levels and patient satisfaction and convenience, were assessed before and 1 year after starting therapy. Results: The study found that 53.3% of Jadenu® patients were satisfied with the taste of the medication compared to only 12.5% of Exjade® patients, which was statistically significant (p = 0.001). Additionally, 40% of Jadenu® patients were satisfied with the ease of taking the medication compared to 28.1% of Exjade® patients, and again, the difference was statistically significant (p = 0.047). A comparison of the cardiac MRI T2* levels between the two studied groups showed no significant difference (p = 0.851). Conclusion: Jadenu® offers patients an improved formulation that can be taken on an empty stomach, has a better taste, and presents fewer gastrointestinal tolerability concerns. Overall, patient satisfaction is higher with Jadenu®, which may improve adherence and reduce the frequency and severity of complications associated with iron overload. This, in turn, may help mitigate cardiovascular and hepatic complications from iron overload in the long term. Clinical Trial Registration: https://irct.behdasht.gov.ir/search/result?query=IRCT20210830052346N1 [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension is one of the most common cardiac complications among patients with β-thalassemia major (β-TM). The aim of this study is to investigate the correlation of pulmonary artery pressure (PAP), serum ferritin level, and cardiac T2* MRI in patients with β-TM. Method: This cross-sectional study was performed on 50 patients older than 7 years old. Echocardiography, electrocardiography, and cardiac T2* MRI were performed on all patients and their serum ferritin levels were measured. Based on the echocardiographic the patients were divided into two groups of PAP>30 and <30 mmHg. Results: 40% had PAP higher than 30 mmHg, 32% had abnormal T2* MRI, and 36% had serum ferritin levels higher than 1500ng/dl. there were significant negative correlations between CMRI *T2 and PAP (-0.36) and the P-pulmonary (-0.29). the serum ferritin level was positively correlated with PAP (0.44) and the P pulmonary in ECG (0.30). in the patients with PAP>30, the means of age, serum ferritin level, and P-pulmonary were significantly higher than patients with PAP<30 (P=0.001). In the patients with PAP>30mmHg, CMRI *T2 had higher accuracy (80%), sensitivity (65%), and specificity (90%) compared to the measurement of serum ferritin levels. Conclusion: The PAP was positively correlated with serum ferritin levels and negatively with T2MRI. The accuracy of 80% for T2MRI as a method to diagnose or even anticipate PH among patients with TM suggested that this method is a useful and accurate method of PH diagnosis and can be used as an alternative among clinicians. [ABSTRACT FROM AUTHOR]

Background: Deferasirox (DFX) is a once-daily oral iron chelator with proven dose-dependent efficacy in patients with thalassemia major (TM). The reason for switching from DFX dispersible tablets (Exjade ® ) to DFX film-coated tablets (Jadenu ® ) was intolerance. Many patients also reported that deferasirox ® did not taste good. In this study, we compared the effect of Jadenu ® and Exjade ® on satisfaction, convenience, cardiac/liver MRI T2*, serum ferritin levels, and biochemical profiles in patients with thalassemia major., Method: Sixty-two patients with thalassemia over 2 years of age, who had iron overload indicated by chelation therapy, were randomly divided into two groups. The first group (n = 32) is treated with Exjade ® , and the second group (n = 30) is treated with Jadenu ® . Laboratory investigations included alkaline phosphatase (ALK), alanine transferase (ALT), aspartate transferase (AST), and serum ferritin levels. Cardiac/liver MRI T2* levels and patient satisfaction and convenience, were assessed before and 1 year after starting therapy., Results: The study found that 53.3% of Jadenu ® patients were satisfied with the taste of the medication compared to only 12.5% of Exjade ® patients, which was statistically significant ( p = 0.001). Additionally, 40% of Jadenu ® patients were satisfied with the ease of taking the medication compared to 28.1% of Exjade ® patients, and again, the difference was statistically significant ( p = 0.047). A comparison of the cardiac MRI T2* levels between the two studied groups showed no significant difference ( p = 0.851)., Conclusion: Jadenu ® offers patients an improved formulation that can be taken on an empty stomach, has a better taste, and presents fewer gastrointestinal tolerability concerns. Overall, patient satisfaction is higher with Jadenu ® , which may improve adherence and reduce the frequency and severity of complications associated with iron overload. This, in turn, may help mitigate cardiovascular and hepatic complications from iron overload in the long term., Clinical Trial Registration: https://irct.behdasht.gov.ir/search/result?query=IRCT20210830052346N1., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mobinikhaledi, Falahati, Tajerian, Hashiani, Ghaffari and Ghasemi.)

Background: In patients with β-thalassemia major (TM), one of the long-term complications of regular blood transfusion is renal dysfunction. The purpose of the current study was to evaluate the renal function in TM patients receiving Exjade ® dispersible tablets and a new film-coated tablet formulation of deferasirox (Nanojade ® )., Materials and Methods: In this descriptive cross-sectional study, a total of 80 TM patients aged 11-48-year-old entered the study. Patients received 20-30 mg/kg/d (single dose) Exjade® (Exjade group, n = 40) and Nanojade® (Nanojade group, n = 40) orally. To evaluated renal function, serum creatinine (S Cr ), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), 24-h urine protein (U Pro ), U Ca /U Cr , spot U Pro /U Cr ratio, and serum ferritin were calculated at baseline and every 3 months to 9 months., Results: There was no significant difference in S Cr , BUN, eGFR, 24-h U Pro , U Pro /U Cr ratio, U Ca /U Cr ratio, and serum ferritin between groups at baseline and end of study ( P baseline > 0.05, P end of study > 0.05). There was no significant difference in proteinuria between groups at baseline and end of study ( P baseline > 0.05, P end of study > 0.05)., Conclusions: The proportion of S Cr , BUN, eGFR, 24-h U Pro , U Pro /U Cr ratio, and U Ca /U Cr ratio was not significantly different in TM patients treated with Nanojade ® compared to patients' received Exjade ® . Nanojade ® had similar effects to Exjade ® , and therefore, the use of Nanojade ® is safe in TM patients and does not seem to be associated with increased renal failure, proteinuria, and hypercalciuria., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Advanced Biomedical Research.)

Background: The role of the hematologic indicators in the identification of severe or critical patients requires further investigation. In this study, we focused on predicting Covid-19 patients at risk of progression using blood parameters., Materials and Methods: We performed a retrospective study including 444 patients with confirmed Covid-19. Hematological parameters were evaluated. The logistic regression analysis was performed with step-wise method with dependent variables such as intensive care units admission, partial pressure of oxygen saturation, and mortality. Also, independent variables such as hematological parameters, age and sex to assess variables that are likely to predict patients at risk of progression., Results: Patients in intensive care units had significantly higher mean absolute neutrophil count than outpatients ( P < 0.001). There was a statistically significant difference in the mean absolute lymphocyte count between dead and survived patients ( P = 0.015). Multivariate analysis confirmed the positive association of the white blood cells ( P < 0.001), absolute neutrophil count ( P < 0.004), red cell distribution width ( P < 0.001), and lactate dehydrogenase ( P = 0.007) to be positively associated with the admission of Covid-19 patients in the intensive care units and the absolute monocyte count ( P = 0.012, Odds ratios = 0.100, CI95% = 0.066-0.605) to be negatively associated with mortality., Conclusion: Based on the results of our study, it is recommended to use hematological data to make clinical decisions and evaluate the patient's prognosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Advanced Biomedical Research.)