KAJIAN LITERATUR: PROFIL PENGGUNAAN DAN EFEKTIVITAS OBAT KELASI BESI PADA PASIEN TALASEMIA MAYOR

Abstrak

Talasemia mayor merupakan kelainan darah genetik yang memerlukan transfusi darah secara rutin. Transfusi berulang dapat menyebabkan penumpukan zat besi (iron overload) dalam tubuh sehingga diperlukan terapi kelasi besi untuk mencegah komplikasi organ. Kajian ini bertujuan untuk mengetahui profil penggunaan dan efektivitas obat kelasi besi pada pasien talasemia mayor. Metode yang digunakan adalah kajian literatur dengan pendekatan deskriptif terhadap literatur melalui (Data base) basis data Google Scholar, PubMed, ScienceDirect, dan Scopus. Data dikaji berdasarkan jenis obat, dosis, frekuensi, rute pemberian, kepatuhan penggunaan, serta efektivitas terapi berdasarkan perubahan kadar feritin serum dan luaran klinis yang dilaporkan. Hasil kajian menunjukkan bahwa obat kelasi besi yang banyak dibahas meliputi deferasiroks, deferipron, dan deferoksamin. Pada studi terdahulu, deferasiroks merupakan obat yang paling banyak digunakan (53,08%), diikuti deferipron (46,92%), dengan ketepatan dosis dan frekuensi mencapai 96,15%. Efektivitas terapi ditunjukkan oleh penurunan rata-rata kadar feritin serum, seperti pada penggunaan deferasiroks tablet (928 ng/mL), deferipron sirup (874 ng/mL), dan deferipron tablet (491 ng/mL) pada populasi anak. Namun, efektivitas terapi juga dipengaruhi oleh kepatuhan pasien, di mana kepatuhan yang rendah (60%) berhubungan dengan tingginya kadar feritin serum (>2.500 ng/mL). Secara keseluruhan, penggunaan obat kelasi besi perlu disesuaikan dengan kebutuhan pasien dan disertai pemantauan dosis serta kepatuhan secara berkala untuk mendukung keberhasilan terapi serta mengurangi risiko komplikasi akibat kelebihan zat besi.

Thalassemia major is a genetic blood disorder that requires regular blood transfusions. Repeated transfusions can cause iron accumulation (iron overload) in the body; therefore, iron chelation therapy is needed to help reduce iron overload and prevent organ complications. This study aims to determine the profile of use and effectiveness of iron chelation drugs in patients with thalassemia major. The method used was a literature review with a descriptive approach, using literature obtained from Google Scholar, PubMed, ScienceDirect, and Scopus databases. Data were reviewed based on drug types, dosages, frequency, routes of administration, medication adherence, and therapeutic effectiveness based on changes in serum ferritin levels and reported clinical outcomes. The results show that the iron chelation drugs frequently discussed include deferasirox, deferiprone, and deferoxamine. Previous studies indicate that deferasirox was the most frequently used drug (53.08%), followed by deferiprone (46.92%), with dosage and frequency accuracy reaching 96.15%. Therapeutic effectiveness was reflected by a reduction in mean serum ferritin levels, notably with deferasirox tablets (928 ng/mL), deferiprone syrup (874 ng/mL), and deferiprone tablets (491 ng/mL) in pediatric populations. However, therapeutic success is strongly influenced by patient adherence, where low adherence (60%) is associated with elevated serum ferritin levels (>2,500 ng/mL). Overall, the use of iron chelation drugs needs to be adjusted to individual patient needs and accompanied by regular monitoring of dosage and adherence to support therapeutic success and reduce the risk of complications caused by iron overload.