Martin Griesshammer, MD, PhD, Johannes Wesling University Clinic, discusses past and current efforts to improve treatment options for patients with polycythemia vera.
Real-world studies are crucial in understanding how best to optimize treatment options for patients with polycythemia vera (PV), says Martin Griesshammer, MD, PhD, professor and medical director of the Department of Haematology, Haemostaseology, Oncology, and Palliative Care, at Johannes Wesling University Clinic.
What can be done to optimize the treatment of PV in elderly patients or those with comorbidities?
Elderly patients with PV have special interests because we know that the rate of cardiovascular and cerebrovascular events is elevated in PV. And this is especially true for elderly patients because they have a higher risk for getting cerebral and cardiovascular problems. We should make a common effort together with a cardiologist and an angiologist to establish the best treatment for these elderly patients.
What research efforts are currently underway to address the unmet needs in PV treatment?
What we do at the moment is, of course, trials about the real world. And there has been very interesting analysis of Francesca Palandri [Francesca Palandri, MD, PhD, Institute of Hematology "L. and A. Seràgnoli", Sant'Orsola-Malpighi University Hospital, Bologna, Italy] focusing on the real-world problem. So that means, for example, what are we going to do with patients that are resistant or intolerant to hydroxyurea? Are they really switched to ruxolitinib? This is not the case. Only 30% of the patients having resistance to hydroxyurea are really switched to ruxolitinib, [and] that should be 100%. All these efforts and studies and analysis in the real-world setting will help to improve in the future therapy for our PV patients.
There's been more research into the use of ruxolitinib for the treatment of PV, including a study you worked on that compared the drug to standard therapy and a study being presented at EHA 2023 evaluating it as a second-line therapy. What other research is needed to convince providers and federal agencies to get behind the use of this drug for patients with PV?
Ruxolitinib has been established and licensed for PV since 2014, in Germany and Europe. We now have nearly a 10-year experience. It's a very reliable drug with very few side effects; it is very effective over many years, and it really helps patients with PV. It is necessary to carry on with these results and have other real-world analysis to reassure us that it is an excellent second-line therapy.