PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Chelation Therapy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2005

Acute prooxidant effects of vitamin C in EDTA chelation therapy and long-term antioxidant benefits of therapy.

Chelation therapy is thought to not only remove contaminating metals but also to decrease free radical production. EDTA chelation therapy, containing high doses of vitamin C as an antioxidant, is often used in the treatment of diseases such as diabetes and cardiovascular diseases but the effectiveness of this treatment may be variable and its efficacy has not been demonstrated conclusively. The objective of this work was to determine if the vitamin C added to standard chelation therapy cocktails was prooxidant. We administered a standard EDTA cocktail solution with or without 5 g of sodium ascorbate. One hour following the standard chelation therapy, there were highly significant prooxidant effects on lipids, proteins, and DNA associated with decreased activities of RBC glutathione peroxidase and superoxide dismutase while in the absence of sodium ascorbate, there were no acute signs of oxidative damage. After 16 sessions of standard chelation therapy, the acute prooxidant effects of vitamin C remained, but, even in the absence of nutrient supplements, there were beneficial long-term antioxidant effects of chelation therapy and plasma peroxide levels decreased. In conclusion, multiple sessions of EDTA chelation therapy protect lipids against oxidative damage. However, standard high amounts of vitamin C added to EDTA chelation solutions also display short term prooxidant effects. The added benefits of lower levels of vitamin C in chelation therapy need to be documented.

Adult↗
PubMed2002

Inhibition of warfarin anticoagulation associated with chelation therapy.

Chelation therapy originally was administered exclusively to patients with heavy metal poisoning. Now some physicians are administering this therapy for numerous conditions, most commonly coronary heart disease. A 64-year-old man experienced impaired warfarin anticoagulation after undergoing chelation therapy His international normalized ratio (INR) fell from 2.6 the day before to 1.6 the day after therapy was administered. Whether chelation therapy decreases the effectiveness of warfarin anticoagulation is uncertain. However, because of this potential interaction, clinicians should consider increased INR monitoring in patients undergoing chelation therapy.

Anticoagulants↗
PubMed1990

Apparent failure of edetic acid chelation therapy for the treatment of coronary atherosclerosis.

Patients diagnosed with incurable or fatal diseases may seek alternatives to standard medical therapy and spend significant amounts of money for these therapies. One alternative medical therapy, chelation therapy with edetic acid (EDTA), has gained considerable popularity for the alleged treatment of atherosclerotic vascular disease; however, its efficacy for this indication remains unproven and its use is controversial. We present a case in which chelation therapy was unsuccessful in treating coronary atherosclerosis and review reports that substantiate a lack of efficacy using chelation therapy in the treatment of coronary atherosclerosis. Treatment of atherosclerotic-related diseases using chelation therapy should be discouraged by health professionals. Patients should be counseled regarding the risk of improper diagnosis and treatment of their disease.

Aged↗
PubMed2006

New chelation therapies and emerging chelating drugs for the treatment of iron overload.

Iron chelation therapy using deferoxamine or deferiprone (L1) is effective for the treatment of most transfused iron-loaded patients. The combination administration of deferiprone in the daytime and deferoxamine in the night appears to be universally effective in rapidly achieving negative iron balance. The cardiac iron removal effect of deferiprone increases the prospects of longer survival in beta-thalassaemia patients. New chelators have reached the stage of clinical development such as deferitrin, 1-allyl-2-methyl-3-hydroxypyrid-4-one (L1NAll) and the starch deferoxamine polymers. Deferasirox has received a conditional approval in the US under the FDA-accelerated approval regulations, but needs further verification of its efficacy and safety. Future iron chelation therapies are likely to be based on combinations of chelating drugs.

Carboxylic Acids↗
PubMed1995

Iron chelation therapy.

Iron chelation therapy is essential to prevent death from cardiac toxicity in patients with thalassemia major or other severe refractory anemias who need regular blood transfusions. Iron chelating drugs also have potential for clinical use as antiproliferative agents in neoplastic diseases and to reduce free radical-induced tissue damage in rheumatoid arthritis, anthracycline-induced cardiotoxicity, and reperfusion injury. Experimental data and clinical trials also suggest they may have therapeutic value as adjuncts to antimalarial and anti-Pneumocystis carinii therapy and to reduce aluminum toxicity. There is therefore an urgent need for an orally active, inexpensive iron chelating drug, because desferrioxamine, the only currently widely available iron chelator, must be given parenterally and is expensive, making it unavailable for long-term use in many parts of the world. L1 (also known as deferiprone, 1-2 dimethyl-3-hydroxpyrid-4-one, DMHP, and CP20) has emerged as an orally active iron chelator with comparable efficiency to desferrioxamine in both short- and long-term clinical studies. Adverse side-effects, principally agranulocytosis and arthropathy, have raised doubts about its safety, and further trials are now planned to evaluate the incidence of these and other toxicities. Despite numerous studies, no other orally active agent has been shown in clinical trials to be as effective or as safe as L1.

Cardiomyopathies↗
PubMed2002

Chelation therapy.

Explore the source record for details and available documents.

Chelating Agents↗
PubMed1976

Chronic industrial exposure to lead in 63 subjects. II. Evaluation of chelation therapy.

Efficacy of chelation therapy with intravenous calcium disodium edetate, oral Ca EDTA, and oral penicillamine was tested in 63 subjects with chronic minimal industrial exposure to lead. All three agents increased the urinary lead excretion. The effect was greatest with intravenous Ca EDTA, next with oral penicillamine and least with oral Ca EDTA. Symptoms, particularly colicky abdominal pain, improved during the period of chelation therapy. Anaemic subjects showed improvements in haematological parameters. It is recommended that subjects with chronic minimal industrial exposure to lead receive chelation therapy. The relative merits of the three agents are discussed.

Adult↗
PubMed2006

Deaths associated with hypocalcemia from chelation therapy--Texas, Pennsylvania, and Oregon, 2003-2005.

Chelating agents bind lead in soft tissues and are used in the treatment of lead poisoning to enhance urinary and biliary excretion of lead, thus decreasing total lead levels in the body. During the past 30 years, environmental and dietary exposures to lead have decreased substantially, resulting in a considerable decrease in population blood lead levels (BLLs) and a corresponding decrease in the number of patients requiring chelation therapy. Chelating agents also increase excretion of other heavy metals and minerals, such as zinc and, in certain cases, calcium. This report describes three deaths associated with chelation-therapy--related hypocalcemia that resulted in cardiac arrest. Several drugs are used in the treatment of lead poisoning, including edetate disodium calcium (CaEDTA), dimercaperol (British anti-Lewisite), D-penicillamine, and meso-2,3-dimercaptosuccinic acid (succimer). Health-care providers who are unfamiliar with chelating agents and are considering this treatment for lead poisoning should consult an expert in the chemotherapy of lead poisoning. Hospital pharmacies should evaluate whether continued stocking of Na2EDTA is necessary, given the established risk for hypocalcemia, the availability of less toxic alternatives, and an ongoing safety review by the Food and Drug Administration (FDA). Health-care providers and pharmacists should ensure that Na2EDTA is not administered to children during chelation therapy.

Chelating Agents↗
PubMed1984

Chelation therapy of atherosclerosis.

Chelation therapy with intravenous injections of edetate disodium is being promoted to the public as a nonsurgical means to treat coronary or other arterial atherosclerosis. The rationale for use, clinical efficacy, and safety are reviewed. Acceptable evidence supporting chelation therapy for atherosclerotic vascular disease is lacking.

Adult↗
PubMed2005

Iron chelation therapy.

Although iron chelation therapy with deferoxamine (DFO) has changed life expectancy in thalassemic patients, compliance with the rigorous requirements of long-term subcutaneous DFO infusions is unsatisfactory. This problem underlines the current efforts for developing alternative, orally effective chelators to improve compliance and treatment results. For the patient with transfusional iron overload in whom results of DFO treatment are unsatisfactory, several orally effective agents are now available. The most important of the new generation of oral chelators are deferiprone and ICL670. Total iron excretion with deferiprone is less than with DFO, but deferiprone has a better ability to penetrate cell membranes and may have a better cardioprotective effect than DFO. Current studies of the clinical efficacy and tolerability of ICL670 indicate that at a single oral dose of 20 mg/kg daily, it may be as effective as parenteral DFO used at the standard dose of 40 mg/kg daily. Combined chelation treatment, employing a weak chelator that penetrates cells better, and a stronger chelator with efficient urinary excretion, may result in improved therapeutic effect through iron shuttling between the two compounds. The efficacy of combined chelation treatment is additive and offers an increased likelihood of success in patients previously failing DFO or deferiprone monotherapy.

Administration, Oral↗
PubMed2002

Chelation therapy for atherosclerotic cardiovascular disease.

BACKGROUND: Chelation therapy is being promoted and practiced all over the world as a form of alternative medicine in the treatment of atherosclerotic cardiovascular disease. It has been recommended as a safe, relatively inexpensive and non-surgical method of restoring blood flow in atherosclerotic vessels. At present the benefit of chelation therapy remains controversial at best. OBJECTIVES: The objective of this review is to assess the effects of ethylene diamine tetraacetic acid (EDTA) chelation therapy on clinical outcomes among patients with atherosclerotic cardiovascular disease. SEARCH STRATEGY: The reviewers searched the Cochrane Peripheral Vascular Diseases Group Trials Register, (last searched July 2002), the Cochrane Controlled Trials Register, (Cochrane Library Issue 2, 2002), MEDLINE and EMBASE for published articles and other relevant articles. Studies were also requested through correspondence with known Filipino practitioners of the procedure. SELECTION CRITERIA: Studies were included if they were randomized controlled trials of EDTA chelation therapy versus placebo or no treatment in patients with atherosclerotic cardiovascular disease. Main outcome measures considered included either total or cause-specific mortality, non-fatal cardiovascular events, direct or indirect measurement of disease severity, subjective measures of improvement or adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers (MVV, FT) extracted data and assessed trial quality independently. Unresolved issues were considered by a third reviewer (ALD). Discrepancies were discussed until a consensus was reached. Authors were contacted for additional information. MAIN RESULTS: A total of five studies was included in the review. Mortality, non-fatal events, and cerebrovascular events were not reported in any of the studies. Four of the studies, with a total recruitment rate of 250 participants, showed no significant difference in the following outcomes: direct or indirect measurement of disease severity and subjective measures of improvement. One of the studies, which included only 10 patients, was interrupted prematurely, because of an apparent treatment effect. However, relevant data were not available in the report and have been requested from the authors. REVIEWER'S CONCLUSIONS: At present, there is insufficient evidence to decide on the effectiveness or ineffectiveness of chelation therapy in improving clinical outcomes of patients with atherosclerotic cardiovascular disease. This decision must be preceded by conducting randomized controlled trials that would include endpoints that show the effects of chelation therapy on longevity and quality of life among patients with atherosclerotic cardiovascular disease.

Arteriosclerosis↗
PubMed1999

EDTA chelation therapy does not selectively increase chromium losses.

Chelation therapy and supplemental Cr have both been shown to lead to improved blood glucose, lipids, and insulin activity. Chelation therapy leads to the removal of toxic as well as essential metals. To determine if chelation therapy leads to increased urinary Cr losses and altered Cr homeostasis, 2 groups of subjects (1 group that had undergone only 1 or no chelation therapy and 1 group in which all subjects had undergone at least 19 chelation sessions) were evaluated for differences in possible Cr homeostasis based on urinary Cr losses. There were no significant differences in urinary Cr losses between the two groups of subjects and there were no significant increases in urinary Cr losses resulting from chelation therapy. Increases in urinary Cr losses were strongly influenced by supplementation but not chelation therapy.

Aged↗
PubMedDate not supplied

Role of EDTA chelation therapy in cardiovascular diseases.

Chelation therapy is a widely practised mode of treatment for atherosclerotic cardiovascular diseases all over the world. However, evidence for the utility of this therapy is limited and conflicting. We did a systematic review of the literature. The reference listings of the articles, obtained from a Pubmed search using relevant keywords, were searched for additional related articles. Most of the evidence supporting the use of EDTA chelation therapy is from case reports, small series or uncontrolled, open-label clinical trials. The published randomized controlled trials include few patients and their results are of limited value. Uncontrolled studies have reported symptomatic improvements but the few controlled trials suggest that these benefits are due to a placebo effect. The available data do not support the use of chelation in cardiovascular diseases. This therapy should be used only in the context of a research trial including patients who have failed to respond to conventional treatment.

Atherosclerosis↗
PubMed1996

Serum neopterin, interleukin-4, and interleukin-6 concentrations in cerebral malaria patients and the effect of iron chelation therapy.

To determine if iron chelation therapy alters immune responses in children with cerebral malaria, we retrospectively measured mean serum levels of neopterin, interleukin-4 (IL-4), and IL-6 in children who received desferrioxamine B or placebo for three days in addition to quinine-based therapy. Mean levels of neopterin, IL-4, and IL-6 were elevated above the expected normal range on admission. Neopterin correlated significantly with the degree of anemia, IL-4 with the duration of fever prior to admission, and IL-6 with parasite density. Serial measurements of cytokines and neopterin were performed over four days in 39 children, 21 randomized to receive desferrioxamine B and 18 to receive placebo. Mean concentrations of neopterin did not change significantly in either group while levels of IL-4 increased significantly in the placebo group (P = 0.04) but remained unchanged in the desferrioxamine B group. Interleukin-6 concentrations decreased markedly in both groups (P < 0.025). Stable IL-4 levels in children given desferrioxamine B may represent an inhibition of the T helper lymphocyte-2 (TH-2) response resulting from a strengthened TH-1 response associated with iron chelation therapy. Any effect of iron chelation on immunity in the setting of severe malaria will have to be confirmed in future prospective investigations.

Biopterins↗
PubMed2001

Iron chelation therapy in sickle cell disease.

Iron chelation therapy with deferoxamine enhances iron excretion and removes excessive tissue iron in regularly transfused patients with sickle cell disease. Long-term studies of deferoxamine in other hemoglobinopathies demonstrate that regular chelation therapy also reduces iron-related organ damage and mortality. Careful design of chelation regimens and attention to compliance are critical elements of successful therapy. The role of new chelators in sickle cell disease is currently under Investigation.

Anemia, Sickle Cell↗
PubMed2001

Use of chelation therapy after coronary angiography.

PURPOSE: Among patients who had undergone coronary angiography, we sought to determine the proportion of chelation therapy users, their sociodemographic and clinical characteristics, and the association of chelation therapy with subsequent revascularization. METHODS: We studied all patients who underwent coronary angiography in the province of Alberta, Canada, during 1995 and 1996. The cohort was followed for up to 6 years to determine subsequent revascularization status. Use of chelation therapy was determined by a mailed survey 1 year after angiography. RESULTS: Among the 5854 patients who responded to the mail survey (70% response rate), 210 (3.6%) reported current use of chelation therapy and 252 (4.3%) reported past use. Current use of chelation therapy was associated with extensive coronary artery disease (adjusted odds ratio [OR] = 3.3; 95% confidence interval [CI]: 1.9 to 5.7 for 3-vessel disease; and OR = 2.7; 95% CI: 1.2 to 6.0 for left main disease, as compared with those with normal anatomy) and the absence of diabetes (OR = 0.6; 95% CI: 0.4 to 0.9). Current users were less likely to have undergone percutaneous transluminal coronary angioplasty (OR = 0.7; 95% CI: 0.5 to 0.9) and coronary artery bypass graft (CABG) surgery (OR = 0.3; 95% CI: 0.2 to 0.5) in the first year after angiography, but were as likely as nonusers of chelation therapy to have undergone CABG surgery in the subsequent 3- to 5-year period (adjusted hazard ratio [HR] = 1.1; 95% CI: 0.7 to 1.9). Past use of chelation therapy was associated with a history of CABG surgery before coronary angiography (OR = 1.6; 95% CI: 1.1 to 2.3) and extensive coronary artery disease. Past users were also more likely to have undergone CABG surgery in the follow-up period (HR = 1.7; 95% CI: 1.1 to 2.6). CONCLUSIONS: About 8% of patients who underwent cardiac catheterization for coronary artery disease were using or had previously tried chelation therapy. Users may have foregone revascularization in favor of this less invasive yet unproven treatment, with some users subsequently undergoing conventional treatment after chelation. Alternatively, some patients may have turned to chelation as a "last resort" after having been judged unsuitable for revascularization.

Aged↗
PubMed1995

New concepts of iron and aluminium chelation therapy with oral L1 (deferiprone) and other chelators. A review.

The introduction of oral chelation therapy with the alpha-ketohydroxypyridine chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1, INN/BAN: deferiprone) in iron- and aluminium-overloaded patients has been initiated in over 15 countries in the last 7 years. Over 600 patients with various conditions, in 26 centres have received L1, in some cases daily for over 5 years. In the vast majority of iron-loaded patients, doses of 55-100 mg kg-1 of L1 resulted in urinary iron excretion levels greater than those accumulating from transfusions (15-35 mg d-1) and also reduction in serum ferritin and liver iron to near normal levels. Urinary iron excretion was related to the iron load of the patients, as well as the dose and frequency of administration of L1. The L1 appears to mobilize iron mainly from a serum iron pool in excess of transferrin saturation, transferrin-bound iron and tissue iron, mainly but not exclusively from the liver. The order of metal binding by L1 at pH 7.4 is Fe > Cu > A1 > Zn. Aluminium removal from aluminium-loaded renal dialysis patients by L1 was also effective at doses similar to those used for iron-loaded patients. Overall toxic side effects include six cases of reversible agranulocytosis, 0-30% incidence of transient musculoskeletal and joint pains, 0-6% of gastric intolerance and 0-2% zinc deficiency. Deferiprone appears to be as effective as desferrioxamine in iron and aluminium removal and has low toxicity. Its oral efficacy and low cost make it more accessible than desferrioxamine for the vast majority of patients needing iron chelation worldwide. The development of other alpha-ketohydroxypyridines is currently in progress.

Aluminum↗