There is currently no cure for polycythemia vera (PV), but researchers are looking at new treatments that may help better manage and control the progression of the condition.

Polycythemia vera (PV) is a rare chronic blood condition that can cause thrombosis (blood clots), itchy skin, and several other symptoms.

Although there is currently no cure, various treatments can help manage the condition and improve life expectancy.

Read on for more information about some of the newer treatments being studied and implemented.

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PV is a slow developing chronic illness that affects the bone marrow and blood. The condition causes the body to create too many red blood cells and can also cause it to create too many white blood cells and platelets.

At first, PV may not cause symptoms. In many cases, a routine blood test finds evidence of PV before any symptoms present.

Treatment options typically focus on a few different areas of the condition. The primary goal of treatment is to help prevent thrombosis (blood clots) from occurring. Blood clots can lead to conditions such as heart attack or stroke if they travel to the heart or brain.

The secondary goal of treatment is to help improve quality of life. Doctors may prescribe medications or make recommendations to help prevent itchiness or depression symptoms.

Some current research is looking more closely into the use of JAK2 inhibitors to treat PV. Treatments focusing on the JAK2 gene may help with improving symptoms of the disease.

When treating PV, a healthcare professional’s primary goal is to prevent the formation of blood clots, which can lead to deadly complications such as heart attack or stroke.

Therapies are also used to:

  • reduce hematocrit concentration, or the percentage of red blood cells in the blood, to normal or close-to-normal levels
  • decrease other PV-related symptoms
  • lower platelet counts, if their concentrations are high

The Leukemia & Lymphoma Society states that treatments are split into one of two categories: low risk patients and high risk patients.

Low risk patients are people younger than 60 years of age with no history of blood clots, while high risk patients are people who are 60 years or over or who have a history of blood clots.

Standard treatments

Treatment options for both high and low risk patients include phlebotomy and aspirin. Phlebotomy is the regular drawing of blood to reduce the amount of blood cells in the body. Low dose aspirin can help reduce the risk of blood clots.

Specific medications

Doctors will likely prescribe one or more medications to help reduce the number of blood cells in the bodies of high risk patients.

Some common medications used for this include:

  • busulfan (Myleran)
  • hydroxyurea (Hydrea)
  • interferon alfa (Intron A)
  • ruxolitinib (Jakafi)

Additional therapies

Doctors may also work with people to help reduce symptoms of itching.

No single treatment works for every person, but some treatments for itchiness that may help include:

  • applying topical or oral antihistamines
  • taking less frequent baths or showers
  • using cool water in the shower or bath
  • using gentle soaps or other skin products
  • avoiding heated whirlpools, hot showers or baths, and hot tubs
  • trying light therapy
  • not scratching the skin
  • using moisturizers
  • taking medications such as pregabalin and gabapentin

Researchers are exploring new treatment options. Recent clinical trials have looked at therapies such as:

  • Rusfertide: Rusfertide is a hepcidin mimetic that doctors can administer by injection. A current study is evaluating rusfertide in maintaining hematocrit control and improving symptoms.
  • Selective serotonin reuptake inhibitors: These are typically used for depression, but they may also help reduce itchiness.
  • JAK2 inhibitors: These help block a mutated JAK2 gene from producing too many blood cells. Ruxolitinib is a JAK2 inhibitor showing some promise in the treatment of PV.
  • Givinostat: This is a histone deacetylase medication that helps prevent abnormal cell growth. It may be a second line of treatment for people whose bodies do not tolerate first line treatments well.
  • Pegylated interferon alfa-2a (Pegasys): This is a JAK2 inhibitor targeting the JAK2 gene. It may benefit people with PV.
  • Idasanutlin: This is an MDM2 inhibitor that blocks certain protein interactions. However, it may not be suitable for long term use.

Anyone interested in participating in a clinical trial can visit ClinicalTrials.gov for a list of PV-related studies.

A person should talk with their doctor about participating in a clinical trial. They may be able to advise the person on where to find a study near them and help determine whether they would be a good candidate.

There is currently no cure for PV. However, treatments can help improve quality of life.

The average life expectancy for PV without treatment is around 18 months. With effective treatment, the average life expectancy is 14 years overall, and 24 years if a person is under the age of 60 years.

Ongoing medical treatment is important to improving both symptoms and life expectancy. A person should not stop taking medications designed to help reduce blood clots without talking about it with their doctor first.

Polycythemia vera (PV) treatments currently focus on helping prevent thrombosis (blood clots) and negative complications from them, such as heart attack and stroke.

Future treatments may help with improving quality of life and increasing life expectancy even further.

A person who is interested in taking part in a clinical study should contact a doctor to find out about current studies taking place.