地拉罗司应注意哪些事项呢？

The U.S. Food and Drug Administration (FDA) approved on January 23 for the treatment of chronic iron overload in patients with β-thalassemia older than 6 years old due to frequent blood transfusions (monthly administration of concentrated red blood cells ≥7 mL/kg). For children under 6 years old and iron overload caused by other transfusion-dependent diseases, the safety and effectiveness data of deferasirox in Chinese patients are limited, and it is recommended to use it with caution based on the specific situation of the patient.

What should you pay attention to when taking deferasirox?

1. Auditory interference: Hearing loss and high-frequency hearing loss have been reported (rarely) with use; perform an auditory test before starting and at regular intervals (every 12 months) during use; if abnormalities occur, monitor closely and consider dose reduction or treatment interruption.

Myelosuppression: Cytopenia (including agranulocytosis, neutropenia, thrombocytopenia, and worsening anemia) (some fatal) has been reported; patients with pre-existing blood disorders may be at increased risk; monitor blood counts regularly. Interrupt treatment in patients who develop cytopenia; may restart once cause of cytopenia is determined; contraindicated if platelet count <50,000/mm3.

3. Skin toxicity: May cause rash (dose related); mild to moderate rash may resolve without interrupting treatment; for severe rash, interrupt and consider restarting with dose escalation and lower doses of oral steroids. Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme have also been reported; the risk of other skin reactions including drug reactions with eosinophilia and systemic symptoms cannot be excluded.

4. Gastrointestinal events: Gastrointestinal bleeding (including death) may occur; more common in patients with advanced hematological malignancies and/or elderly patients with low platelet counts; discontinue treatment for suspected gastrointestinal bleeding or ulceration. Nonfatal upper GI irritation, bleeding, and ulceration (sometimes complicated by GI perforation, including death) have been reported. Use concomitant medications that may increase the risk of adverse GI effects (e.g., NSAIDs, corticosteroids, anticoagulants, oral bisphosphonates) with caution and monitor patients closely for signs/symptoms of GI ulceration/bleeding while taking these medications.