Efficacy and side effects of deferiprone (L1) in thalassemia patients not compliant with desferrioxamine

We report our experience with deferiprone (L1) (DFP) in 17 thalassemic pati ents, followed up in one center in Lebanon, who were initially on desferrio xamine and then shifted to DFP at a dose of 50-75 mg/kg/day as the sole che lator during 1-year follow-up. Ail 17 patients were compliant with therapy and there was no change in physical examination over the study period. Eigh t patients (47.1%) were positive for hepatitis C virus (HCV) antibodies. Ur inary iron excretion was 21.8 +/- 14 mg/24 h (mean +/- SD) 1 week after sta rting DFP and dropped 12 months later to 13 +/- 7.4 mg/24 h (p = 0.009, pai red t test). The initial serum ferritin level was 3,863 +/- 2,344 mu g/l wh ich dropped to 3,179 +/- 2,075 at 12 months after starting therapy (p = 0.0 7). HCV-negative patients as a group exhibited a significant decrease in se rum ferritin after 6 and 12 months of DFP therapy(3,942 +/- 2,739 vs. 2,341 +/- 1,179 and 2,681 +/- 1,519 mu g/l; p < 0.03 and p < 0.05, respectively) . The most frequent side effects were joint pain, stiffness or swelling in 6 patients (35.3%), and nausea in 7 patients (41.2%), but these were well t olerated and did not require stopping treatment.