NEJM EvidenceRopeginterferon versus Standard Therapy for Low-risk Patients with Polycythemia Vera

Could ropeginterferon alfa-2b be the new standard for treating low-risk Polycythemia vera?

The Low-PV phase 2 trial provides new insights into the treatment of low-risk Polycythemia vera (PV), comparing the efficacy and safety of ropeginterferon alfa-2b (ropeg) to a stringent phlebotomy-only program.

Key Points:

• The trial found ropeg to be superior in maintaining patients’ hematocrit at or below the target level of 45% without thrombotic events, progression of leukocytosis, thrombocytosis, or worsening of splenomegaly.
• At 12 months, 81% of patients in the ropeg group and 51% in the phlebotomy group met the primary end point.
• After a further 12 months of observation, 83% of ropeg responders and 59% of phlebotomy-only responders maintained their responses.

Additional Points:

• Ropeg treatment led to normal leukocyte and platelet counts, normal blood ferritin levels, reduction of disease-related symptoms, and a progressive reduction of JAK2V617F allele burden.
• The safety profile of ropeg needs to be further evaluated in larger cohorts and over a longer period.

Conclusion:

• The study suggests that ropeg could be a more effective treatment than the standard treatment of therapeutic phlebotomy and aspirin for patients with low-risk PV.

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Did You Know?
Polycythemia vera is a rare, chronic disorder and according to the American Cancer Society, the median survival is about 14 years.