As iron continues to build up in the body, complications happen more often.1

Comparing sickle cell disease patients with iron overload to those without iron overload, a review of clinical trials in 2018 showed that sickle cell patients with iron overload had higher rates of: 3

mortality (64% vs. 5%)

organ failure (71% vs. 19%)

pain episodes (64% vs. 38%)

Defined as serum ferritin levels >1,500 ng/mL and transferrin saturation >50%  3

Monitor renal toxicity

Kidney complications are common in patients with sickle cell disease – affecting 30-50% of adults.12 Regular monitoring of both renal and hepatic toxicity can help optimise chelation and ensure patients are on an appropriate chelator.1

Chelation therapy needs to be individually tailored for each patient to respect their lifestyle and to minimise toxicity.1

Iron chelation needs to be adjusted regularly or even switched depending on iron level, weight, and tolerance to side effects.1,2

Sickle Cell Disease treatment guidelines support regular monitoring of serum ferritin, and cardiac and liver MRI T2*‡1,11
Parameter Target Expert panel recommendation
Serum ferritin 25-300 ng/mL Monthly
Liver iron concentration (LIC) 800-3,500 µg/g dry weight Every 1-2 years
Cardiac MRI T2* >20 ms Performed for patients with:
  • sickle cell disease with a high iron burden (liver iron content >15 mg/g [dry weight (dw)]) for 2 years or more
  • evidence of end organ damage because of transfusional iron overload
  • or evidence of cardiac dysfunction

Frequency of monitoring and reference values may differ depending on country of practice. Please refer to your local guidelines.

Iron chelation therapy results in better overall survival in sickle cell disease, but only if it is instituted early and compliance is maintained1

For HCP: In case you want to report an adverse drug reaction you become aware of, please report it to your Health Authority according to the requirements set by the pharmacovigilance legislation.