BESREMi Achieves Strong Market Growth Amid Rising Demand for Polycythemia Vera Treatment

[Manouche]

 »BESREMi is expected to reach peak adoption in the US by 2027 before late-stage competitors like rusfertide gain a foothold. Our analysis suggests that BESREMi will maintain a competitive lead for at least five years before new entrants like rusfertide establish themselves. Furthermore, with BESREMi's patent set to expire in 2034, the eventual introduction of generics could lead to a sharp revenue decline. The market dynamics are expected to shift in the coming years due to increased first-line use of BESREMi for polycythemia vera, the anticipated launch of a pen-device version, potential expansion into additional indications, and broader global availability. »

benzinga.com/pressreleases/...

[Luthorville]

Rusfertide works quite differently from Besremi, and I’m skeptical that many patients will switch from Besremi to Rusfertide, as they serve distinct purposes. Rusfertide, a hepcidin mimetic, primarily focuses on controlling hematocrit (HCT) by regulating iron availability, reducing the need for phlebotomy. It is not designed to impact allele burden (AB), though a potential effect on AB has not been ruled out. In contrast, Besremi (ropeginterferon alfa-2b) not only helps manage HCT but also actively reduces JAK2-mutated clone size, leading to a decrease in allele burden over time.

I could see a scenario where both drugs are used together—Besremi targeting the underlying disease and lowering AB, while Rusfertide provides faster HCT control, potentially reducing reliance on phlebotomy. However, since no clinical studies have evaluated this combination, it’s unclear how effective or safe it would be.

Jakafi (ruxolitinib) might also be impacted by Rusfertide’s emergence, as its use has been gradually increasing earlier in polycythemia vera treatment. While primarily used in later-stage PV for patients resistant or intolerant to hydroxyurea, Jakafi does help control HCT, though its main role remains symptom management and spleen size reduction.

I am trying to post the full names and abbreviations...I know when I first started seeing AB, HCT, PV, and every other abbreviation made it hard.

[EPguy]

I agree with Luthorville, and most regulars here likely agree, Rusf is not a direct competitor. This report seems AI generated. The inclusion of Rusf that way suggests the AI was not intimate with PV, which is reasonable. But it may have one use as an adjunct to Bes, for pts with inadequate HCT control on IFN alone.

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"...given the severe side effects associated with JAK inhibitors" "it differentiates itself as a potentially more tolerable, non-myelosuppressive option with a lower risk of treatment-related malignancies."

All of HU, IFN, and Rux are myelosuppressive by intention so this statement is strange. The point on malignancies is valid vs Rux, re non-melanoma skin cancer. But I have an issue with their assertion of relative tolerance of Rux vs IFN. Rux has plenty of sides, but If we look to severe sides, and esp sudden severe ones, IFN has this risk uniquely as we are seeing here.

The AI also needs to get up to speed on the new small molecule agents in trials. If these work out, IFN could have a whole new sort of competition.

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Another AI like item: "The treatment landscape for polycythemia vera has evolved significantly, shifting from conventional approaches like aspirin, hydroxyurea, interferons, and phlebotomy to more advanced therapies, including JAKAFI (approved in 2014) and BESREMi"

Bes is absolutely interferon with all that implies. And PEG beat them to the pegylated version. With all that he Peg-IFNs are very good therapies.