The identification of ketotifen as a novel cardioprotective agent in
patients undergoing anthracyclines chemotherapy
Abstract
Objective: The present study aimed to investigate the possible
cardioprotective effects of ketotifen and to assess its activity as an
iron-chelating agent in patients receiving anthracyclines for the
treatment of breast cancer. Patients & Methods: This was a randomized,
prospective, controlled clinical trial. One hundred eleven eligible
patients with breast cancer (age range, 30-60 years) were scheduled to
receive anthracyclines chemotherapy. The patients were divided into two
groups: Patients (n = 56) assigned to the ketotifen group received
ketotifen 1 mg three times daily for six consecutive cycles of
treatment, and patients assigned to the control group (n = 55) without
ketotifen treatment. The echocardiogram for each patient was recorded
two times at baseline and the end of the study. As well, blood samples
were collected from all patients. Results: The findings showed a
statistically significant reduction in the mean serum levels of common
cardiotoxicity accompanied biomarkers in the ketotifen group compared
with the control group (P ≤ 0.05). The mean serum levels of total
iron-binding capacity were significantly elevated in the ketotifen group
(P ≤ 0.001). There was a direct correlation between the mean serum
levels of iron and that of lactate dehydrogenase (LDH) (r = + 0.79). On
the other hand, there were indirect correlations between mean serum
levels of LDH and both the percentage of ejection fraction and the total
iron-binding capacity (r = - 0.69 and -0.697, respectively). Conclusion:
Oral administration of ketotifen appears to be efficient and safe as a
novel cardioprotective agent for the prevention of anthracyclines
induced cardiotoxicity. Additionally, ketotifen suggested a beneficial
effect in iron overload inducing diseases such as COVID-19.