A double-blind, controlled, crossover trial of amlodipine on iron overload status in transfusion dependent β-thalassemia patients

Background and aim This study examined whether administration of amlodipine could improve myocardial iron loading status in patients with transfusion dependent beta-thalassemia (TDT), through a placebo-controlled, crossover study. Methods Amlodipine (5 mg, daily) or placebo were prescribed to all patients (n = 19) for 6 months, and after a 2-week washout period, patients were crossed over to the other group. The efficacy of amlodipine on iron loading was assessed by measuring myocardial T2*-weighted magnetic resonance imaging (MRI T2*, millisecond [ms]) and serum ferritin (ng/mL). Results Seventeen patients completed the study. The mean +/- standard deviation [SD] of myocardial MRI T2* at baseline was 9.83 +/- 2.67 ms Myocardial MRI T2* value rose to 11.44 +/- 4.14 ms post amlodipine treatment in all patients. After placebo, myocardial MRI T2* value reached 10.29 +/- 4.01 ms After controlling the baseline measures, Hedges's g for ferritin and myocardial MRI T2* outcomes were estimated 3.84 (95% confidence interval [CI] 2.68 to 4.97) and -1.80 (95% CI -2.58 to -0.10), respectively. Conclusion Amlodipine might improve myocardial MRI T2* and serum ferritin level compared to placebo. However, larger clinical studies are needed to confirm the results.

Automated summary

This study found that amlodipine may improve myocardial MRI T2* and serum ferritin levels compared to placebo. However, larger clinical studies are needed to confirm these results.