Deferasirox
| Evidence Level: L5 | Predicted Indications: 5 |
Table of Contents
Deferasirox: iron chelator → HIV infectious disease
One-Sentence Summary
Deferasirox is an oral iron chelator. The TxGNN model predicts it may be relevant to HIV infectious disease, but there are no registered clinical trials and only 2 publications, one a general drug review and one an in vitro study, so the evidence is very limited.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | HIV infectious disease |
| TxGNN Prediction Score | 0.9940 |
| Evidence Level | L5 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Deferasirox is known as an iron chelator, so its effects are expected to relate to iron availability in cells.
Iron status is known to influence HIV-1 replication. A 2021 laboratory study (PMID 34550543) reported that iron held in endolysosomes restricts Tat-mediated HIV-1 LTR transactivation by changing Tat oligomerization. This offers a plausible but indirect iron-homeostasis link. The study did not test deferasirox, and it does not show that deferasirox has antiviral activity. Iron chelation could plausibly act in either direction, helping or hindering viral replication.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 34550543 | 2021 | Preclinical/In vitro | Journal of Neurovirology | Endolysosomal iron restricted Tat-mediated HIV-1 LTR transactivation by increasing Tat oligomerization and β-catenin expression. Deferasirox was not shown to be tested. |
| 16529348 | 2006 | Review | Journal of the American Pharmacists Association | General new-drug review covering several agents including deferasirox. No abstract is available and it does not address HIV directly. |
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| ARTG 11231D | Deferasirox Juno | Tablet, dispersible, 500 mg | Not recorded in the local data |
Cytotoxicity
Deferasirox is not an antineoplastic drug, so this section does not apply.
Safety Considerations
- Drug Interactions (100 interactions listed in the data compiled for this report; examples below):
- Major: hydrocortisone, dexamethasone, betamethasone, triamcinolone, acetylsalicylic acid, mesalazine, balsalazide, and several amphotericin B formulations.
- Moderate: rabeprazole, pioglitazone, alosetron, aprepitant, clarithromycin, saxagliptin, aluminium hydroxide, cisapride, and dexfenfluramine.
For warnings and contraindications, please refer to the TGA-approved Product Information (PI).
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no clinical trials and no study of deferasirox in HIV. The only supporting paper is an in vitro study on iron and Tat, which is an indirect link. No cited study directly addresses deferasirox in HIV infection, so the evidence level is L5.
To proceed, the following is needed:
- Laboratory studies testing deferasirox directly against HIV-1 replication, including whether chelation helps or harms
- Detailed mechanism of action data
- Review of the TGA Product Information for warnings and contraindications, particularly for people with HIV who may have liver or kidney disease or take interacting medicines
- Any registered or planned clinical studies of iron chelation in HIV
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.