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Ropeginterferon alfa-2b in Polycythemia Vera: A systematic review and meta-analysis
Danyal Bakht1, Hafiz Muhammad Haris1, Zahra Sania2
1King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan.
Medicine
|August 7, 2026
Summary
Ropeginterferon alfa-2b shows no significant advantage over hydroxyurea for polycythemia vera (PV) but offers superior short-term efficacy compared to phlebotomy alone, particularly for molecular and hematologic responses.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Ropeginterferon alfa-2b is a novel monopegylated interferon for polycythemia vera (PV).
- Evidence comparing its efficacy and safety to standard treatments is limited.
- This study evaluates ropeginterferon alfa-2b against hydroxyurea and phlebotomy in PV management.
Purpose of the Study:
- To compare the efficacy of ropeginterferon alfa-2b with standard PV therapies.
- To assess complete hematologic response (CHR), partial molecular response (PMR), and JAK2V617F allele burden reduction.
- To synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- Systematic literature search of 4 databases up to April 2025, adhering to PRISMA 2020 guidelines.
- Inclusion of RCTs comparing ropeginterferon alfa-2b with hydroxyurea or phlebotomy in PV patients.
- Meta-analysis using random-effects models and RoB 2.0 for bias assessment.
Main Results:
- Three RCTs with 522 patients were analyzed.
- Ropeginterferon alfa-2b showed no significant advantage over hydroxyurea for CHR, PMR, or JAK2 allele reduction.
- Significant benefits were observed over phlebotomy alone for CHR, PMR, and allele burden reduction.
Conclusions:
- Ropeginterferon alfa-2b is not significantly different from hydroxyurea but superior to phlebotomy in short-term PV efficacy.
- Favorable molecular and hematologic outcomes support its role as a disease-modifying therapy.
- Larger, longer-term trials are needed to confirm benefits in broader PV populations.
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