From the Guidelines
Elevated iron levels should be treated with therapeutic phlebotomy, removing one unit of blood (about 200-250 mg iron) weekly, to reduce tissue iron stores and improve survival, sense of well-being, and cardiac function, as recommended by the American Association for the Study of Liver Diseases 1. The primary goal of treatment is to reduce iron stores to normal levels, which can be achieved through regular phlebotomy sessions.
- Key benefits of phlebotomy include:
- Improved survival if diagnosis and treatment are initiated before the development of cirrhosis and diabetes
- Improved sense of well-being and energy level
- Improved cardiac function
- Reduction in abdominal pain and skin pigmentation
- Normalization of elevated liver enzymes
- The frequency of phlebotomy sessions may vary depending on the individual's iron stores and tolerance, but typically ranges from once to twice a week, with maintenance phlebotomies every 2-4 months once iron levels normalize 1.
- It is essential to monitor serum ferritin levels regularly, approximately every 3 months, to assess the effectiveness of treatment and adjust the phlebotomy schedule as needed 1.
- Additionally, patients with elevated iron levels should avoid supplemental vitamin C, as it can accelerate iron mobilization and increase the risk of sudden death, particularly in those with advanced disease 1.
- The European Association for the Study of the Liver (EASL) also recommends phlebotomy as the primary treatment for HFE-hemochromatosis, with a similar treatment approach and monitoring schedule 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Iron Levels Elevated
Elevated iron levels can be a result of various factors, including frequent blood transfusions, which can lead to iron overload in the body. This condition can cause damage to internal organs and increase the risk of certain diseases.
- Iron overload can occur in individuals with conditions such as beta-thalassemia, myelodysplastic syndrome, and sickle cell disease, which require frequent blood transfusions 2, 3.
- Deferasirox is an oral iron chelator that has been shown to be effective in reducing iron burden in iron-overloaded patients with beta-thalassemia, sickle cell anemia, and myelodysplastic anemia 2, 3.
- Desferrioxamine mesylate is another iron chelator that has been used to manage transfusional iron overload in people with transfusion-dependent thalassaemia 4.
- Deferasirox has been compared to desferrioxamine in several studies, with results showing that deferasirox can achieve similar efficacy to desferrioxamine in reducing iron stores, but with a higher incidence of adverse effects 2, 4, 5.
- The diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia are crucial, especially in high-risk populations such as women of reproductive age, children, and patients with chronic diseases 6.
Treatment Options
Treatment options for iron overload include iron chelation therapy, which can help remove excess iron from the body.
- Deferasirox is a once-daily oral agent that has been approved for the treatment of iron overload in patients with transfusional iron overload 2, 3.
- Desferrioxamine mesylate is a traditional therapy for iron overload, but it requires overnight infusion and has a demanding therapeutic regimen, leading to poor compliance 4.
- Deferiprone is another oral iron chelator that has been shown to be effective in reducing iron stores, but it has a higher incidence of adverse effects compared to desferrioxamine 4.
Monitoring and Prevention
Monitoring and prevention of iron overload are essential to prevent long-term complications.
- Regular monitoring of iron levels, liver function, and renal function is necessary for patients receiving iron chelation therapy 4, 5.
- Patient education and compliance with treatment regimens are crucial to prevent iron overload and its complications 3, 5.
- Prevention of iron deficiency and iron deficiency anemia is also important, especially in high-risk populations, through dietary modifications and supplementation 6.