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Underutilization of cytoreductive therapies for PV: A German observational study
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PV is characterized by an overproduction of erythrocytes, with elevated production of leukocytes and thrombocytes and an increased risk of TEs. Cardiovascular comorbidities may further increase the risk of TEs and are associated with worse survival outcomes.1 Conclusive data on the epidemiology and cytoreductive management of PV are lacking.1 To provide estimates of PV epidemiology, characterize those at risk for TEs including those with comorbid cardiovascular risk factors, review current cytoreductive treatments, and assess the occurrence of TEs over time, Manz et al.1 conducted a retrospective analysis based on German health claims data from January 1, 2014, to December 31, 2022. Their findings were published in Annals of Hematology.1 |
| Key learnings |
| 937 patients with prevalent PV were identified in the claims database, corresponding to a prevalence of 28.6 per 100,000 in the German adult population. 83.2% of prevalent patients were identified as being at high risk for TE complications. |
| Contrary to treatment guidelines, 43.6% of high-risk patients did not receive cytoreductive treatment. 63.5% of patients treated with HU (but no RUX) met HU intolerance/resistance proxy criteria. |
| A lower proportion of patients with TEs was observed over time in patients continuously treated with RUX compared to patients treated with HU who also met HU intolerance/resistance proxy criteria (35.8% vs 56.3% after 3 years; p < 0.05). |
| These findings suggest that available cytoreductive therapies are not fully utilized according to current treatment guidelines. Suboptimal treatment may increase the risk of avoidable TEs in patients with PV, highlighting the need for further research and compliance with guidelines. |
Abbreviations: HU, hydroxyurea; PV, polycythemia vera; RUX, ruxolitinib; TE, thromboembolic event.
- Manz KC, Mocek A, Morouj B, et al. Prevalence, incidence, and thromboembolic events in polycythemia vera: a study based on longitudinal German health claims data. Ann Hematol. 2025. Online ahead of print. DOI:
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