Anagrelide: a decade of clinical experience with its use for the treatment of primary thrombocythaemia.
Primary thrombocythaemia (PT) is the most frequent among the rare chronic myeloproliferative disorders. Life expectancy is determined by thromboembolic and haemorrhagic complications, which can be prevented by cytoreductive therapy. For a long time, hydroxyurea has been considered as the therapeutic gold standard. However, hydroxyurea treatment is not lineage-specific, may not be tolerated because of adverse effects (skin, gastrointestinal tract) and is leukaemogenic when sequentially used with other DNA-targeting drugs. Hence, anagrelide was welcomed in 1988 when it was first described as being efficient at normalising elevated platelet counts, specific for megakaryocytes and non-mutagenic. Since then, anagrelide has been approved in the US and Canada (Agrylin), Shire Pharmaceuticals) as well as in Austria and other countries of the EU (Thromboreductin), AOP Orphan Pharmaceuticals). Clinical Phase III trials (PT1 and ANAHYDRET) are underway to directly compare the efficacy and safety of anagrelide and hydroxyurea.
Petrides
Petro E
PE
Hematology Oncology Center, Zweibruckenstr. 2, 80331 Munich, Germany. Petrides@onkologiemuenchen.de
D000818:Animals; D002273:Carcinogens; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D007370:Interferon Type I / Q000627:therapeutic use; D009153:Mutagens; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010976:Platelet Count; D011799:Quinazolines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011994:Recombinant Proteins; D013920:Thrombocythemia, Essential / Q000097:blood / Q000188:drug therapy*; D013923:Thromboembolism / Q000517:prevention & control
D002273:Carcinogens; D007370:Interferon Type I; D009153:Mutagens; D010975:Platelet Aggregation Inhibitors; D011799:Quinazolines; D011994:Recombinant Proteins; C021139:anagrelide; D006918:Hydroxyurea