Deferasirox for porphyria cutanea tarda: a pilot study.

OBJECTIVE

To determine the efficacy and safety of deferasirox (an oral iron-chelating agent approved to reduce iron stores in patients with chronic iron overload due to blood transfusions) in a pilot trial for the treatment of patients with porphyria cutanea tarda (PCT), the most common of the porphyrias and often difficult to treat.

DESIGN

Prospective, open-label, noncomparative study.

SETTING

University-affiliated tertiary health care center in Dallas, Texas.

PATIENTS: Ten patients with PCT were enrolled in this 6-month study. The diagnosis was established by documenting the presence of elevated porphyrin level in the urine and a history of developing 3 or more blisters per month for at least 3 months prior to enrollment. Patients were treated with 250 mg/d of deferasirox, with an increase to 500 mg/d after 2 months if new blisters continued to develop.

MAIN OUTCOME MEASURE: The improvement in number of blisters at the end of the 6-month treatment period was assessed.

RESULTS

Of 10 patients, 8 completed the study. Seven had resolution of blistering, 6 had a reduction in urinary porphyrin levels, and 7 had a reduction in ferritin levels. The treatment was well tolerated.

CONCLUSIONS

In this small pilot study, deferasirox induced improvement in cutaneous findings of PCT in 8 patients who completed 6 months of treatment. Most patients also had a substantial reduction in urinary porphyrin and ferritin levels. Future larger controlled studies are needed to confirm these findings. Deferasirox may be a useful alternative to existing treatment modalities for PCT.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00599326.