Therapeutic trial of effective erythropoietin suppression in children affected with beta-thalassemia major: a three-year follow-up

ABSTRACT

A Three-year follow up study was conducted on 45 regularly transfused beta-thalassemic children; 23 of them were also given captopril therapy [6.25-12.5mg b.i.d.]. The aim was to evaluate the efficacy of captopril in inducing more effective suppression of erythropoiesis. Twenty age and sex matched controls were included at the end of study. All thalassemics were evaluated for their blood pressure [BP], hemoglobin [Hb], blood urea, serum creatinine, alkaline phosphatase, alanine aminotransferase, reticulocytic index [RI], serum ferritin, serum erythropoietin [sEpo] and serum transferrin receptors [s Tfr]; at the start and at the end of the study. Results showed that subjects given captopril, after 3 years therapy, had lower sEpo, sTfr and RI [31, 9, and 1.41 versus 60 mU/ml, 16 microg/ml, 2.3 respectively]; less incidence of splenomegaly [39 versus 77%]; higher height velocity and weight values; compared to thalassemics without captopril therapy [P<0.05]. Captopril used in regularly transfused beta-thalassemics could induce better suppression of endogenous erythropoiesis with reasonable cost, fair compliance and no side effects