{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:29Z","timestamp":1772168849022,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.128810.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000}}],"reference-count":32,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in \u03b2-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in \u03b2-thalassemia major patients. Methods A cross-sectional observation was performed on 102 patients with \u03b2-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman\u2019s rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators\u2019 effects between those receiving short-term (\u22647 years) and long-term (&gt;7 years) blood transfusion were also analyzed. Results The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 and\n                    <ns3:italic>p<\/ns3:italic>\n                    &lt;0.001) and AST ((r=0.569; p&lt;0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups (\n                    <ns3:italic>p<\/ns3:italic>\n                    =0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group (\n                    <ns3:italic>p<\/ns3:italic>\n                    =0.001 and 0.022, respectively). Total (\n                    <ns3:italic>p<\/ns3:italic>\n                    &lt;0.001), indirect (\n                    <ns3:italic>p<\/ns3:italic>\n                    &lt;0.001), and direct bilirubin levels (\n                    <ns3:italic>p<\/ns3:italic>\n                    =0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance of\n                    <ns3:italic>p<\/ns3:italic>\n                    =0.008 in the long-term transfusions group. Conclusions Ferritin is high in people with transfusion-dependent \u03b2-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.128810.2","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T04:40:09Z","timestamp":1702960809000},"page":"154","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of oral iron chelators in the management of transfusion-dependent \u03b2-thalassemia major based on serum ferritin and liver enzymes"],"prefix":"10.12688","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4979-1259","authenticated-orcid":false,"given":"Sulaiman","family":"Yusuf","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heru Noviat","family":"Herdata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eka Destianti","family":"Edward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khairunnisa","family":"Khairunnisa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"692-703","DOI":"10.1111\/ejh.13512","article-title":"Changing patterns in the epidemiology of \u03b2-thalassemia.","volume":"105","author":"A Kattamis","year":"2020","journal-title":"Eur. 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Risk Manag."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"3436-3441","DOI":"10.1182\/blood-2006-02-002394","article-title":"Oral chelators deferasirox and deferiprone for transfusional iron overload in thalassemia major: new data, new questions.","volume":"107","author":"E Neufeld","year":"2006","journal-title":"Blood."},{"key":"ref32","doi-asserted-by":"publisher","article-title":"Underlying data for \u2018Comparison of oral iron chelators in the management of transfusion-dependent \u03b2-thalassemia major based on serum ferritin and liver enzymes\u2019.","author":"S Yusuf","DOI":"10.6084\/m9.figshare.21564114"}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/12-154\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-154\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-154\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T07:20:14Z","timestamp":1725348014000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/12-154\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,19]]},"references-count":32,"URL":"https:\/\/doi.org\/10.12688\/f1000research.128810.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.128810.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.160173.r231351","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.160173.r231351","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,19]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/12-154\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.160173.r231351, Pustika Amalia Wahidiyat, Department of Child Health, Division of Hematology-Oncology, Cipto Mangunkusumo General Hospital, University of Indonesia, Jakarta, 03 Sep 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-154\/v2#referee-response-231351","order":0,"name":"referee-response-231351","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.141435.r208966, Ahmed Yahya Dallal Bashi, Al-Noor University College, Mosul, 24 Nov 2023, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/12-154\/v1#referee-response-208966","order":1,"name":"referee-response-208966","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sulaiman Yusuf<\/b>; \n<i>Posted: 14 Dec 2023<\/i>; Dear Reviewer,  Thank you for your important suggestions. Here are our responses for each comments.  1. Method: The doses of the 2 drugs were not mentioned which are very important as different protocols of treatment use different daily drugs doses. \n<b>Response: The dosage of the iron chelation used in the study has been added in the article.<\/b> &nbsp; 2. Under the title &quot;\n<i>serum parameters analysis<\/i>&quot; methods for the estimation of serum; ferritin, AST, and ALT were mentioned while method of estimation of serum bilirubin was not mentioned. \n<b>Response: The method used to measure the serum bilirubin has been added under the heading of &nbsp;&quot;Serum parameters analysis&quot;. Thank you. <\/b>  3.&nbsp;Results: The mean length of the patients that was measured in meters was written as&nbsp;\n<i>&quot;125.96&plusmn;18.06&quot;.<\/i>&nbsp;This is in cm and if a meter unit is required then it is 1.2596&plusmn;0.1806. The same fault was repeated in table 1. \n<b>Response: Thank you for pointing this issue. The values are now have been changed to metre: 1.25&plusmn;0.18.<\/b> &nbsp; 4. Discussion:&nbsp;\n<i>&quot;Following the blood transfusion, irons are retained in the macrophages due to the increased hepcidin, hence elevation in serum ferritin.17&quot;<\/i>. Hepcidin production is suppressed due to erythropoietic activity which allows increased absorption of dietary iron in addition to the iron obtained from blood transfusion. \n<b>Response: The text have been revised. Thank you.<\/b> &nbsp; 5. The authors used the scientific names of the drugs which are general names of the main constituent of the drug. I think they have to use the trade names of the drugs and in 2 brackets the constituents of the drugs as follows: Ferriprox (deferiprone) and Exjade (deferasirox). \n<b>Response: Thank you for your suggestion. We have used the style \u201cFerriprox &reg; (iron chelation containing deferiprone) or Exjade &reg; (iron chelation containing deferasirox)\u201d in Introduction (aim) and at the beginning of the Methods section. This is help authors to have detailed information of the drugs used. We avoid to write the name of trading names in all texts of the article since it might less appropriate. This might have perception that the study funded by the companies of the drug. In addition, we used one brand only for each of the drug in this study with is Ferriprox &reg; for deferiprone and Exjade &reg; for deferasirox. <\/b>  6.&nbsp;Aim of the study was mentioned in the &quot;background&quot; only and have to be repeated in more details at the end of the &quot;Introduction&quot;. In addition, in aim of the study mentioned in the &quot;Background&quot; I suggest adding (on the liver) and substituting the word (toxicity) by (adverse effects) so it become (This study aimed to compare the performance and adverse effects of deferiprone and Deferasirox on the liver in \u03b2-thalassemia major patients). \n<b>Response: Thank you for raising this issue. The aim has been revised in the introduction and located at the end of the Introduction. It is now: \u201cThe objective of the study was to compare the performance and adverse effects of two oral iron chelating drugs (i.e., deferiprone (Ferriprox) and deferasirox (Exjade)) on the liver in \u03b2-thalassemia major patients with chronic transfusion. The effect on the liver were assessed by measuring the levels of serum ferritin, transaminase (ALT), aspartate transaminase (AST), total bilirubin, indirect bilirubin and direct bilirubin among patients with \u03b2-thalassemia major and chronic transfusion. In addition, we performed a correlation test between serum ferritin with ALT, AST, and total bilirubin.<\/b>  7.&nbsp;In my opinion the authors went many times out of the scope of the aim of the study which leads to a relatively long article and can be summarized to fulfill the aim of the study. \n<b>Response: Thank you for your suggestion. Since we have two main objectives: To compare the performance and adverse effects as well as to determine the correlation test between serum ferritin with ALT, AST, and total bilirubin; therefore, the article a quite long since we have to prepare the manuscript based on the aims of the study. Now the aims have been articulated clearly in the end of the Introduction.<\/b>","URL":"https:\/\/f1000research.com\/articles\/12-154\/v2#referee-comment-10770","order":2,"name":"referee-comment-10770","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}