Comparative Effects of JadenuⓇ and ExjadeⓇ in Beta Thalassemia Major: Patient Satisfaction, MRI T۲*, Ferritin, and Biochemical Profiles

Background: Deferasirox (DFX) is an oral iron chelator administered once daily, with established dose-dependent efficacy in patients with thalassemia major (TM). The film-coated tablet formulation (Jadenu®) was introduced to address tolerability issues and poor palatability associated with the dispersible tablet formulation (Exjade®). This study aimed to compare the two formulations with respect to patient satisfaction, convenience, serum ferritin levels, biochemical indices, and cardiac/hepatic iron burden assessed by MRI T۲*. Methods: A randomized controlled study was conducted on ۶۲ patients with TM, aged ۲ years, requiring chelation therapy for iron overload. Participants were allocated to receive either Exjade® (n = ۳۲) or JadenuⓇ (n = ۳۰). Clinical and laboratory evaluations included serum ferritin, liver function tests [alkaline phosphatase (ALK), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], and cardiac/hepatic MRI T۲* measurements at baseline and after ۱۲ months. Patient-reported satisfaction and convenience were assessed using structured questionnaires. Results: Patients receiving JadenuⓇ reported significantly greater satisfaction with taste compared to ExjadeⓇ (۵۳.۳% vs. ۱۲.۵%, p = ۰.۰۰۱). Similarly, convenience of administration was rated higher among JadenuⓇ recipients (۴۰.۰% vs. ۲۸.۱%, p = ۰.۰۴۷). No statistically significant differences were observed in cardiac MRI T۲* values between the two groups (p = ۰.۸۵۱). Conclusion: JadenuⓇ demonstrates improved acceptability due to enhanced palatability and simplified administration, with fewer gastrointestinal tolerability concerns compared to Exjade®. Improved patient satisfaction may enhance adherence to therapy and thereby mitigate long-term complications of iron overload, particularly cardiac and hepatic morbidity. These findings support the clinical preference for JadenuⓇ in routine management of thalassemia major.