Efficacy and safety of resveratrol, an oral hemoglobin F-augmenting agent, in patients with beta-thalassemia intermedia

Ann Hematol. 2018 Oct;97(10):1919-1924. doi: 10.1007/s00277-018-3392-8. Epub 2018 Jun 21.

Abstract

Recently, resveratrol showed induction of γ-globin mRNA synthesis in human erythroid precursors and reducing oxidative stress in red cells of thalassemia patients in many in vitro studies. We aimed to investigate the efficacy and safety of resveratrol, for the first time, in non-transfusion-dependent beta-thalassemia intermedia (B-TI) in Southern Iran. In this double-blind randomized clinical trial, 54 patients with B-TI were investigated during 6 months between October 2016 and March 2017. Patients were randomly allocated into three groups by simple randomization method. Group 1 (hydroxyurea (HU) and placebo, 18 patients), group 2 (resveratrol/piperine and placebo, 16 patients), and group 3(HU and resveratrol/piperine, 20 patients). Primary end point was considered as change in hemoglobin (Hb) levels and need for blood transfusion. Drug safety was considered as a secondary end point. Mean age of the patients was 28.2 ± 5.6 (18-42) years. Response rate was not significantly different among the three groups (P > 0.05). Higher percentages of adverse events were detected in groups 2 (31.3%) and 3 (25%) compared to group 1 (5.6%). However, the difference was not statistically significant (P > 0.05). All reported adverse events were gastrointestinal symptoms. Resveratrol showed a similar efficacy with HU in the small population of non-transfusion B-TI patients during a 6-month follow-up. Complications, mostly gastrointestinal, were observed more frequently in resveratrol groups compared to the HU group. Although it was not statistically significant, more attention should be given to safety and efficacy of resveratrol as an oral HbF-augmenting agent.

Keywords: Augmenting; Beta thalassemia; Hemoglobin F; Resveratrol.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Alkaloids / administration & dosage
  • Alkaloids / adverse effects
  • Benzodioxoles / administration & dosage
  • Benzodioxoles / adverse effects
  • Double-Blind Method
  • Female
  • Fetal Hemoglobin / drug effects*
  • Fetal Hemoglobin / metabolism
  • Humans
  • Iran
  • Male
  • Piperidines / administration & dosage
  • Piperidines / adverse effects
  • Polyunsaturated Alkamides / administration & dosage
  • Polyunsaturated Alkamides / adverse effects
  • Resveratrol
  • Stilbenes / administration & dosage*
  • Stilbenes / adverse effects*
  • Treatment Outcome
  • Up-Regulation / drug effects
  • Young Adult
  • beta-Thalassemia / blood
  • beta-Thalassemia / drug therapy*

Substances

  • Alkaloids
  • Benzodioxoles
  • Piperidines
  • Polyunsaturated Alkamides
  • Stilbenes
  • Fetal Hemoglobin
  • Resveratrol
  • piperine