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Anagrelide, a selective platelet-lowering agent, was introduced more than a decade ago for the treatment of essential thrombocythemia (ET). However, in 2005, a phase III study showed that anagrelide was inferior to hydroxyurea for thrombus prevention (N Engl J Med 2005; 353:33). Now, European investigators have conducted a randomized, controlled, noninferiority study to determine whether use of the drug should be reconsidered for patients with early-stage ET.
A total of 253 patients with newly diagnosed ET were randomized to receive anagrelide (0.5 mg twice daily) or hydroxyurea (1500 mg daily). Doses were then adjusted to maintain platelet counts between 450,000/µL and 600,000/µL. Bone-marrow examination excluded primary myelofibrosis or po…