Hydrea vs interfon

[VTAR24]

Hi can anyone tell me the difference between hydrea low dose to interferon as I am possibly switching from pegasys interferon to hydrea in the next week or so because of shortage thanks all

[DougyW]

Others are more knowledgeable than me but Hydrea is a chemotherapy that suppresses all blood production. IFN suppresses the JAK2+. Jakafy works in a similar way to Peggy so if you don't want to move to Hydrea then it may be worth asking about that.

[Mishie14]

Yes, the drugs are very different in how they address managing platelets and very different in side effects per my experience. I would prefer taking another IFN until the supply shortage of peginterferon gets straightened out. HU caused horrendous side effects for me starting with the initial low dose and only got worse as doctor increased the dose, could not tolerate what it did to my quality of life. It took 6 weeks to get off of HU--2 weeks on a lower dose and then a full month of no treatment to get HU out of my system. There's also a big difference in cost with HU being much much cheaper than any of the IFNs so doctors may promote it. You might check your insurance to see what coverage options there are at what cost. Making an informed decision is an important step to take. Good luck.

[hunter5582]

Hydroxyurea is an antimetabolite (cytotoxin), which is a form of chemotherapy. It works by inhibiting ribonucleotide reductase, immediately inhibiting DNA synthesis in hematopoietic stem cells and other cells in your body.

Pegasys and the other interferons (e.g., Besremi) are immune modulating therapies. The IFNs have antiproliferative, and immunomodulatory effects. Interferons exert their therapeutic effects by interacting with interferon receptors on the surface of cells, which leads to a cascade of signaling events that affect gene expression and cell behavior.

Jakafi is a JAK-inhibitor. Jakafi inhibits janus-associated kinases (JAK) 1 and 2, leading to disruption of cytokine and growth factor signaling pathways, resulting in cytoreduction.

Anagrelide is another approved option for ET; however, it is second-tier due to a worse adverse effects profile. It works by disrupting postmitotic phase of megakaryocyte development, reducing platelet count. While it is cheap ($56/month) most doctors do not opt for it due to difficulty tolerating the medication.

Each one of these drugs can work for cytoreduction through different mechanisms. Each has its own risk/benefit profile. While hydroxyurea and Pegasys are both off-label for ET, they are in common use for this purpose. Besremi and Jakafi are both in clinical trial for ET, but not approved for this purpose. Besremi and Jakafi are both very expensive so difficult to access, particularly off-label. Hydroxyurea = $25/month. Pegasys = $4,300/month. Jakafi = $14,300/month. Besremi = $16,000/month. The preference many formularies have for hydroxyurea is easy to understand.

We are each different on how we respond to these medications. Some will benefit from and tolerate one but not another. I was refractory to and intolerant of hydroxyurea. I responded much better to the interferons, Pegasys and Besremi. My response, however, does not predict yours.

It is helpful to know more about hydroxyurea when you are considering it. Here is some information that is important to know,

drugs.com/monograph/hydroxy...

epocrates.com/online/drugs/...

oralchemoedsheets.com/sheet...

ethrombo.blogspot.com/2017/...

It is worth noting that you can always give hydroxyurea a temporary try until Pegasys is available again. You may tolerate it without any problems.

Wishing you all the best.

[DougyW in reply to hunter5582]

Thanks for the detail Hunter. Really appreciated

[OZland]

if you have a choice and no negative reaction to interferon I would steer clear from hydrea

[Bridie123]

I was told by a doctor a simple way to picture the difference. Hydroxy is like spraying water ( highly toxic water!) At the top flames of the fire, whereas peginterferon tackles the base of the fire, therefore causing less stress on the bone marrow, so giving it a longer life.