Table 2.
Changes in Chelator Choice and Reasons for Change in Adolescents/Adults (N=258).
| Chelation changes among participants with | a single change | multiple changes | ||
|---|---|---|---|---|
| Ferritin < 2500 ng/mLa N=32 |
Ferritin ≥ 2500 ng/mL N=10 |
Ferritin < 2500 ng/mLa N=28b |
Ferritin ≥ 2500 ng/mL N=24b |
|
| DFO Infusion to Oral Deferasirox | 8 (25%) | 2 (20%) | 14 (15%) | 7 (10%) |
| Oral Deferasirox to DFO Infusion | 3 (9%) | 0 (0%) | 14 (15%) | 9 (13%) |
| Single Chelator to Combination | 6 (19%) | 5 (50%) | 22 (23%) | 26 (37%) |
| Combination to Single Chelator | 5 (16%) | 1 (10%) | 17 (10%) | 14 (20%) |
| Any Chelation to No Chelation | 2 (6%) | 1 (10%) | 6 (6%) | 1 (1%) |
| No Chelation to Any Chelation | 5 (16%) | 0 (0%) | 8 (8%) | 2 (3%) |
| Other | 3 (9%) | 1 (10%) | 15 (15%) | 11 (15%) |
|
| ||||
| Reasons for change | ||||
|
| ||||
| High iron (requires more aggressive treatment) | 4 (17%) | 3 (33%) | 23 (29%) | 22 (40%) |
| Low iron (requires less aggressive treatment) | 2 (8%) | 0 (0%) | 8 (10%) | 1 (2%) |
| Participant or family decision | 4 (17%) | 1 (11%) | 13 (16%) | 6 (11%) |
| New commercial product available | 6 (25%) | 1 (11%) | 2 (3%) | 1 (2%) |
| Participation in a clinical trial | 1 (4%) | 2 (22%) | 14 (18%) | 12 (22%) |
| Illness or complication | 3 (12%) | 1 (11%) | 4 (5%) | 6 (11%) |
| Pregnancy or conception | 2 (8%) | 1 (11%) | 5 (6%) | 1 (2%) |
| Cardiac disease requiring intensification | 2 (8%) | 0 (0%) | 1 (1%) | 3 (5%) |
| Renal dysfunction | 0 (0%) | 0 (0%) | 4 (5%) | 0 (0%) |
| Insurance Issues | 0 (0%) | 0 (0%) | 5 (6%) | 0 (0%) |
| Improve Adherence | 0 (0%) | 0 (0%) | 0 (0%) | 3 (5%) |
a
includes participants without ferritin measurement at baseline. Categorization is as of baseline, and iron levels may have improved or declined over time.
b
96 chelator changes among 28 participants without high baseline ferritin; 70 chelator changes among 24 participants with high baseline ferritin.