Table 1 Contrasting features of ideal and currently approved iron chelators
From: Polymeric nanocarriers for the treatment of systemic iron overload
Chelator property | Ideal chelator | DFO | L1 | DFX |
|---|---|---|---|---|
Cost | Affordable for patients in low income countries | Moderate | Moderate | Unaffordable and unavailable for most |
Route of Administration | Oral | i.v injection or s.c infusion | Oral | Oral |
Circulation t1/2 | Long enough to allow once-daily dosing and effective iron removal | Short (~20 min) requires all-day (8-12 h) delivery | Moderate; requires at least 3 times per day dosing | Ideal; 8–16 hours, requiring once-daily dosing |
Therapeutic index | High | High at high doses in patients with high burden | Unpredictable | High |
Toxicity | None | Neurotoxic, swelling at infusion sites, bone deformities | Agranulocytosis and mild neutropenia are common | Reversible kidney failure |
Unsaturated Iron Binding Capacity | High: Long enough to prevent drastic fluctuations in LIP | None | Moderate | High |
Ability to remove iron from heart, liver etc. | High | Low | High | High |