Ropeg versus HU/BAT results after 3 years

[Paul123456]

This is very interesting summary of trial results after 3 years.

(CHR is Complete Haematological Response.)

“After 36 months of treatment Ropeginterferon alfa-2b sustained higher CHR response rates compared to HU/BAT (70.5% vs. 51.4%; p=0.0122). Further, the composite endpoint, CHR including disease symptom improvement was higher in patients treated with Ropeginterferon alfa-2b compared to HU/BAT (52.6% vs. 37.8%; p=0.0437).”

and

“66.0% of PV patients treated with Ropeginterferon alfa-2b, but only 27.0% having received HU/BAT showed a mutant JAK2 molecular response (p<0.0001) after 36 months. Importantly, molecular response strongly correlated with CHR, emphasizing the clinical relevance of mutant JAK2 allele burden reduction.

Analysis of additional non-JAK2 mutations, which are believed to contribute to disease progression revealed that Ropeginterferon alfa-2b, but not HU was able to reduce their respective mutant allele burden. This suggests that only Ropeginterferon alfa-2b but not HU has the ability to suppress additional clones with different mutations and modify the disease at the molecular level.”

I’m trying to find out exactly what BAT (Best Alternative Treatment) covers in the HU/BAT Group. ie Venesections/aspirin and Ruxo or does it include Interferons as well?

aoporphan.com/news-media/pr...

[Rachelthepotter]

Great -keep the research coming, Paul. Ropeg looks like a better bet than Pegasys, doesn't it.

[Paul123456 in reply to Rachelthepotter]

That’s the $m question?

I’m not sure. It’s easier to administer (every two weeks) and better tolerability (so possibly allowing higher dosage) but otherwise it should be similar? Just a bit more refined than Pegasys.

Best Paul

[Paul123456 in reply to Paul123456]

I’m told by another poster, more knowledgeable than me, that the difference is as I stated above and Ropeg/Peg should offer similar haematological/molecular response. Ropeg should allow higher dosages for higher risk PV cases.

Also the BAT did not include Pegasys.

[Paul123456]

This is a must watch video. Discusses Peg versus Ropeg and Peg side effects versus HU (different but similar level).

Even just a year ago there was a large question mark over the disease modifying potential of Interferons. Now, as more trial results come in, it appears to me that Interferons gaining ground. Interferons generally need more than 12 months treatment to start strutting their stuff and don’t work on everyone.

patientpower.info/video/upd...

[AndyT in reply to Paul123456]

Very good video!

[Susana7]

Thanks for the update Paul - very interesting! Ropeg should work just as well as Peg but with reduced side effects and extra convenience. Of course, for long term Peg users like myself, on maintenance doses and injecting only every 3 weeks or less, there will be little advantage in switching. But Ropeg will be really great for new and more recent users. What I found really interesting was the correlation found between the lowering of the allele burden of JAK2 (and non-JAK2) mutations and normalisation of blood counts as the role of the allele burden has not been well established (and indeed is not measured routinely in the U.K.). Thanks again for sharing! Susana x

[amalekh]

Hi Paul,

I don't see any content in the shared page, is it only for me?

The other 2 $m questions for me are whether this combination would work with patients done already with Ruxolitinib or intolerant to it. And what's the overall survival rate of Rupeg?

Cheers,

Malek.

[Paul123456 in reply to amalekh]

Malek

Link appears to have stopped working.

There are current trials of combo Ruxo/Pegasys with encouraging initial results in MF.

The theory is that the Ruxo improves inflammatory pathways so that Pegasys more effective.

I’ve been wondering to what extent low inflammation in our bodies improves Pegasys efficacy. eg it’s known that smoking increases inflammation along the pathways Pegasys uses but what about a poor diet?

Best Paul

[Wyebird]

You are doing a great job thank you

[PT99]

Thanks for providing these updates Paul. Much appreciated.

Pete

[Bluetop]

Really looks like a step change from Hu. Thanks Paul

[platelet51]

HU/BAT was only HU

However interestingly patients were only allowed onto the PROUD PV study if they had NOT responded to HU.. bit of a bias.

Did you check MPDRC112 Pegasys vs HU?

[Paul123456 in reply to platelet51]

Agreed, implies more aggressive disease?

Re MPD rc 112, do you have a link to latest update? I know there were a number of trial updates re Pegasys but can’t remember if this one included. Thought the trial closed several years ago?