startup Besremi and what about Anagrelide?

[Jomalile]

hi, at this moment I take Anagrelide for ET, but now that I am diagnosed with PV also, I will start up Besremi. I would like to start with Besremi very slow and not too raise the dose too fast. I read here that often Hu is combined with Besremi in the first months. Is that also possible with Anagrelide? Has somebody has an experience, or are there studies about combining these two?

[hunter5582]

Sorry to hear that your progressed from ET to PV (with thrombocytosis). The same thing happened to me.

I have not heard of anyone switching from anagrelide to Besremi since it is not typically used for PV. The decision about whether to overlap the previous cytoreductive medication is typically made on a case by case basis. This is something to discuss with a MPN Specialist familiar with using the interferons.

I absolutely agree with the low and slow approach to using Besremi. Some docs will now slowly rise to 200mcg then hold rather than following the more rapid titration until reaching hematologic targets. My own experience supports the slower approach. While besremi has been effective and more tolerable than other meds, I would not pretend that it is an entirely benign drug. Caution in dosing is prudent.

Wishing you all the best.

[Jomalile in reply to hunter5582]

Thank you Hunter. Do you know if there are papers/studies about a slow approach? I would like to show it to my hematologist.

[hunter5582 in reply to Jomalile]

I have not seen any papers on the low and slow approach, but have heard it mentioned at MPN Conferences. Some MPN experts prefer this approach for their patients. It is certainly something others pn the forum using esremi support. Ultimately, this is about shared decision making. Your input and preferences in how to titrate Besremi or any other medication are the final determinant of how to approach treatment. While your provider can advise and prescribe, only you can decide. The best prodivers respect their patient's right to make decisions.

[Jomalile in reply to hunter5582]

Thanks again! I like your last sentence.

[Spoalllen]

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