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Am J Med. 2013 Sep;126(9):834-7. doi: 10.1016/j.amjmed.2013.05.002. Epub 2013 Jul 3.

Amlodipine reduces cardiac iron overload in patients with thalassemia major: a pilot trial.

Author information

1
Internal Medicine Department, University of Campinas (Unicamp), Brazil. jlaraf@fcm.unicamp.br

Abstract

BACKGROUND:

Iron chelation therapy in patients with thalassemia major may not prevent iron overload in all organs, especially those in which iron enters cells through specific calcium channels. We designed a controlled pilot study to assess the potential of the calcium channel blocker amlodipine in strengthening the efficacy of iron chelation.

METHODS:

Fifteen patients with thalassemia major undergoing chelation therapy were randomized to receive amlodipine added to standard treatment in a 1:2 allocation for 12 months. T2* values for assessment of iron overload in the liver and heart using magnetic resonance imaging were obtained at baseline and at 6 and 12 months.

RESULTS:

In the amlodipine-treated group, heart T2* increased significantly in comparison to baseline at 6 and 12 months (21.7 ± 7.2 ms to 28.2 ± 7.9 ms and 28.3 ± 8.0 ms, with P = .007 and .03, respectively), while no differences were observed in the control group (25.1 ± 8.8 ms to 24.7 ± 7.8 ms and 26.2 ± 11.4 ms; P = .99 and 0.95, respectively); significant differences between groups were observed at 6 months (28.2 ± 7.9 ms vs 24.7 ± 7.8 ms in the control group, P = .03). A significant reduction in ferritin levels also was observed in the treated group at 12 months.

CONCLUSIONS:

The use of amlodipine in conjunction with standard chelation therapy may suggest a new strategy in preventing and treating iron overload in patients with thalassemia major, especially in organs where iron absorption depends on active uptake by calcium channels like the heart.

KEYWORDS:

Iron overload; Magnetic resonance imaging; Thalassemia

PMID:
23830536
DOI:
10.1016/j.amjmed.2013.05.002
[Indexed for MEDLINE]

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