Ropeginterferon alfa-2b in polycythemia vera: redefining disease control through molecular targeting

This review critically appraises recent clinical and translational advances on ropeginterferon alfa-2b, a long-acting, mono-pegylated interferon that has become a key therapeutic option for polycythemia vera (PV). Beyond its cytoreductive efficacy, ropeginterferon exerts immunomodulatory and antiproliferative effects that may modify disease biology. The review outlines its therapeutic rationale, pharmacologic profile, and emerging role as a disease-modifying agent compared with conventional cytoreductive therapies.

This article summarizes the pharmacokinetic properties, clinical efficacy, molecular activity, and safety of ropeginterferon alfa-2b across pivotal trials and real-world studies. Particular attention is given to hematologic responses, reduction of JAK2 V617F allele burden, and long-term tolerability. Data were identified through a systematic search of PubMed, Embase, and ClinicalTrials.gov for English-language studies published up to 2025.

Ropeginterferon alfa-2b has redefined PV management by combining durable hematologic control with progressive molecular remission. Its favorable efficacy-toxicity balance and convenient dosing support long-term use, particularly in younger or treatment-naïve patients. Future research should refine patient selection, explore predictive biomarkers, and define its role among disease-modifying agents capable of transforming PV into a chronic, potentially controllable disorder.