Iron overload is a significant cause of transfusion-related morbidity and mortality. Deferiprone (DFP) is an oral iron chelator with > 28 years of safety and efficacy data. Initially approved for administration three times a day (TID), a twice-a-day (BID) formulation was developed to improve patient adherence. The United States (US) Food and Drug Administration (FDA) approved DFP BID for transfusional iron overload in patients with thalassemia in 2020, and DFP TID and BID for sickle cell disease (SCD) or other anemias in 2021.

To evaluate the real-world safety profile of DFP, the Ferriprox® Total Care Registry was established in the US. Here, we assess the safety of DFP BID in patients with thalassemia, SCD, or other anemias in real-world clinical practice.

Data were obtained from US patients receiving DFP BID between July 1st 2020–August 31st 2023. DFP exposure: time active in the registry. Frequency of adverse events (AEs) and serious AEs (SAEs) by Medical Dictionary for Regulatory Activities (MedDRA) Preferred Term was assessed.

A total of 425 patients were referred to the Ferriprox® Total Care Registry. Primary diagnoses included “thalassemia” (n = 133, 31.3%), “SCD” (n = 197, 46.4%), “other anemias” (n = 30, 7.1%), and “other indications” (n = 65, 15.3%). Overall, 364 patients (85.6%) were ≥ 18 years of age. An estimated total exposure of 839 patient-years was observed in 412 patients who received ≥ 1 month DFP BID treatment. In total, 1250 AEs and 437 SAEs were reported. All reports of agranulocytosis (2 events) and neutropenia (7 events) recovered. None of the 33 fatal outcomes reported were assessed as possibly or probably related to DFP treatment. DFP BID is well-tolerated in real-world clinical practice in patients with thalassemia, SCD, or other anemias, with no new safety concerns identified compared to DFP TID. Limitations associated with real-world data collection must be acknowledged. Disclosures and financial support This project was funded by Chiesi USA, Inc. Medical writing support was provided by Cactus Life Sciences®, and funded by Chiesi Ltd.