Author, Year
(Quality) | Study Design | Type of Intervention | Years Conducted | N | Age | Duration of followup | Baseline BLL | BLL Results | Summary of Effect |
Rogan, 199860;
Rogan, 200065;
Rogan, 200161;
Liu, 200262;
Dietrich, 200463;
Peterson, 200464; TLC study
(Good) | Randomized multicenter, placebo controlled, double-blind trial | DMSA lasting 26 days, dose based on body surface area; treatment repeated up to 3 times for persistently elevated blood lead level; domestic cleaning with HEPA vacuum and damp cloth wiping. | NR | 1,854 evaluated,
780 randomized
741 of randomized reanalyzed for Liu 2002 (cognitive function) | Children 12-33 months | At 12 months following initiation of treatment, test BLL; at 36 months, planned behavioral, cognitive, and biochemical tests; retest at 72 months (to age 7); also, at 9 and 34 months, test height-weight | 20-44 µg/dL | DMSA vs. Placebo
1 wk: BLL 11 µg/dL lower in DMSA.
7 wks: 72% vs. 88% of baseline.
First 6 months: BLL 4.5 µg/dL lower in DMSA.
12 months: groups are similar. | DMSA produced short-term reduction in BLL; rebound began at 1 week and 7 weeks.
Followup outcomes do not support the hypothesis that lead-induced cognitive defects are reversible by chelation therapy. DMSA group scored worse on some measures. |
Besunder, 199566
(N/A) | Retrospective case series | DMSA 10 mg/kg every 8 hours for 5 days, followed by 10 mg/kg every 12 hours for 14 days; and abatement of domestic lead hazards. | June 1991 to May 1993 | 46 treated, 18 excluded,
N=28 | Children Age NR | 80 days | 25-49 µg/dL | BLL post-treatment:
18 days: -43% (± 20.8%)
80 days -31% (± 20.2%)
ZPP post-treatment:
18 days: -12% (±21.7%)
80 days: -32% (±21.9%) | No control group. Cannot exclude other intervention effects (abatement of domestic lead hazards). |
Chisolm, 200068
(N/A) | Open-label case series | DMSA 1,050 mg/m^2/day, divided in three doses for 5 days, followed by 700 mg/m^2/ day, divided in two doses for 21-23 days; and relocation to lead-safe housing. | NR | 59 | Children 12-65 months | 21 days | 25-70 µg/dL | BLL post-treatment:
1 day: below 35% of pretreatment level.
2-3 weeks: rebounded to 58% of pretreatment level | No control group. Cannot exclude other intervention effects (abatement of domestic lead hazards). |
O'Connor, 199967
(Fair) | Randomized placebo-controlled double-blind trial | DMSA (child weight <15 kg) 1,000 mg tid for 5 days, followed by 100 mg bid for 14 days.
DMSA (child weight >15 kg) 200 mg tid for 5 days, followed by 200 mg bid for 14 days | NR | 39 | Children 2.5-5 years | 6 months | 30-45 µg/dL, DMSA group 34.9 ±4.7 µg/dL
Placebo group 33.0 ±6.2 µg/dL | DMSA vs. Placebo
1 month: 27.4 ±7.5 µg/dL vs. 33.2 ± 10.3 µg/dL
6 months: 28.8 ±6.4 µg/dL vs. 25.1 ±6.8 µg/dL | Both treatment and control groups demonstrated significant BLL reductions. Differences between groups were not significant. |
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