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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Adjunctive Resveratrol or Omeprazole in Patients with Non-Transfusion-Dependent Thalassemia with Iron Overload: A Randomized, Double-Blind, Placebo-Controlled Trial

1 more authors
  1. 1Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
  2. 2Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

Abstract

Increased gastrointestinal iron absorption contributes substantially to iron overload in non-transfusion-dependent thalassemia (NTDT) patients. Resveratrol (RVT) and omeprazole (OMP) may reduce intestinal iron absorption and potentially complement iron chelation therapy. This randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of adjunctive RVT or OMP in adults with NTDT receiving stable iron chelation therapy. The primary outcome was the change in serum ferritin; secondary outcomes influenced serum iron (SI), transferrin saturation (TS), erythroferrone (ERFE), hepcidin, fetal hemoglobin (HbF), and safety. Participants with serum ferritin ≥ 300 ng/mL were randomized (1:1:1) to receive RVT 250 mg, OMP 20 mg, or the placebo (PLA) twice daily for 6 months. Thirty participants were randomized (RVT, n = 10; OMP, n = 11; PLA, n = 9), with a baseline median serum ferritin value of 629 ng/mL, interquartile range (IQR) 484–975. Serum ferritin decreased numerically over 6 months in the RVT and OMP groups relative to PLA; however, no significant treatment × time interactions or adjusted between-group differences in changes from the baseline were observed. Although significant within-group changes were observed for selected iron-regulatory biomarkers, including hepcidin, ERFE, and TS, these were not accompanied by significant treatment × time interactions and did not demonstrate differential treatment effects. Both interventions were generally well tolerated, and no serious adverse events were reported. In this underpowered trial, neither adjunctive RVT nor OMP demonstrated statistically significant treatment-specific effects on serum ferritin or other iron-related outcomes when compared with the placebo. The observed numerical trends warrant evaluation in larger, adequately powered trials. Trial Registration: ISRCTN73258526.

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BibTeX
@article{chopetgool2026adjunctive,
  title = {{Adjunctive Resveratrol or Omeprazole in Patients with Non-Transfusion-Dependent Thalassemia with Iron Overload: A Randomized, Double-Blind, Placebo-Controlled Trial}},
  author = {Thanapong Chopetgool and Chatree Chai-adisaksopha and Ekarat Rattarittamrong and Lalita Norasetthada and Thanawat Rattanathammethee and Sasinee Hantrakool and Pokpong Piriyakhuntorn and Teerachat Punnachat and Nonthakorn Hantrakun and Sirichai Srichairatanakool and Pimpisid Koonyosying and Somdet Srichairatanakool and Adisak Tantiworawit},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = nov,
  doi = {10.3390/ijms27219939},
  url = {https://www.mdpi.com/1422-0067/27/21/9939},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Adjunctive Resveratrol or Omeprazole in Patients with Non-Transfusion-Dependent Thalassemia with Iron Overload: A Randomized, Double-Blind, Placebo-Controlled Trial
AU  - Thanapong Chopetgool
AU  - Chatree Chai-adisaksopha
AU  - Ekarat Rattarittamrong
AU  - Lalita Norasetthada
AU  - Thanawat Rattanathammethee
AU  - Sasinee Hantrakool
AU  - Pokpong Piriyakhuntorn
AU  - Teerachat Punnachat
AU  - Nonthakorn Hantrakun
AU  - Sirichai Srichairatanakool
AU  - Pimpisid Koonyosying
AU  - Somdet Srichairatanakool
AU  - Adisak Tantiworawit
PY  - 2026
DA  - 2026/11/06
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27219939
UR  - https://www.mdpi.com/1422-0067/27/21/9939
AB  - Increased gastrointestinal iron absorption contributes substantially to iron overload in non-transfusion-dependent thalassemia (NTDT) patients. Resveratrol (RVT) and omeprazole (OMP) may reduce intestinal iron absorption and potentially complement iron chelation therapy. This randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of adjunctive RVT or OMP in adults with NTDT receiving stable iron chelation therapy. The primary outcome was the change in serum ferritin; secondary outcomes influenced serum iron (SI), transferrin saturation (TS), erythroferrone (ERFE), hepcidin, fetal hemoglobin (HbF), and safety. Participants with serum ferritin ≥ 300 ng/mL were randomized (1:1:1) to receive RVT 250 mg, OMP 20 mg, or the placebo (PLA) twice daily for 6 months. Thirty participants were randomized (RVT, n = 10; OMP, n = 11; PLA, n = 9), with a baseline median serum ferritin value of 629 ng/mL, interquartile range (IQR) 484–975. Serum ferritin decreased numerically over 6 months in the RVT and OMP groups relative to PLA; however, no significant treatment × time interactions or adjusted between-group differences in changes from the baseline were observed. Although significant within-group changes were observed for selected iron-regulatory biomarkers, including hepcidin, ERFE, and TS, these were not accompanied by significant treatment × time interactions and did not demonstrate differential treatment effects. Both interventions were generally well tolerated, and no serious adverse events were reported. In this underpowered trial, neither adjunctive RVT nor OMP demonstrated statistically significant treatment-specific effects on serum ferritin or other iron-related outcomes when compared with the placebo. The observed numerical trends warrant evaluation in larger, adequately powered trials. Trial Registration: ISRCTN73258526.
SN  - 1422-0067
ER  -