Overall, methods to exogenously or endogenously increase hepcidin levels represent a novel mechanism to eliminate the need for therapeutic phlebotomy in patients with PV and improve their symptoms. Stricter hematocrit control could also lead to a decrease in thrombotic burden, although longer-term evaluation is required to support this claim. Rusfertide, which is the therapeutic furthest along in development, represents a welcome addition to the treatment armamentarium for patients with PV who require frequent therapeutic phlebotomies; it may have an expanded role in the future for patients with symptoms of the disease.
* “Polycythemia vera represents a unique situation, where you have overproduction of red blood cells in the setting of systemic iron deficiency,” Dr. Kuykendall said. Rusfertide was designed to address this particular issue.
* The endogenous hormone hepcidin is the principal regulator of systemic iron homeostasis, controlling iron through downregulation of ferroportin, a transmembrane protein responsible for delivering iron. In iron deficiency, and in polycythemia vera, hepcidin levels are low, and iron freely flows to the bone marrow at the expense of other...
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