Calcium channel blockers use in iron overload for thalassemias with regular blood transfusions
Keywords:
Calcium channel blockers, Iron overload, ThalassemiaAbstract
Iron overload is a common complication of thalassemia. The iron accumulation in any organs causes free radicals that damage cells and then lead to cardiomyopathy which serves as the major cause of death so this complication should be treated appropriately with iron chelators as the mainstay of therapy. Some patients could not achieve target iron level even with maximum dosage of iron chelators. Moreover, a number of them suffer from adverse effects, leading to intolerance to use standard dosage. Therefore, the use of calcium channel blockers, as an adjunctive therapy with iron chelators for iron overload treatment, is an appealling option due to their pharmacological activity that can reduce iron accumulation in myocytes. Several clinical studies have shown that oral calcium channel blockers in addition to standard iron chelators for iron overload in beta thalassemia major with regular blood transfusion have had beneficial effects for reduction in myocardial iron as well as having tolerable adverse effects. Nevertheless, the meta analysis showed that the use of calcium channel blockers as an adjunctive therapy with iron chelators had no significant reduction of iron amount in the heart because there is not enough good quality study thus the true benefits of this therapy can not be concluded. Therefore, further studies are needed in the future and the application of calcium channel blockers to patients with thalassemia should be selected in specific cases with advers effects and failure of target iron level after treatment with all types of iron chelators according to therapeutic guidelines.
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