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Therapeutic efficacy of Anagrelide

A total of 942 patients with myeloproliferative neoplasms including 551 patients with Essential Thrombocythemia (ET),  117 patients with Polycythemia Vera (PV), 178 patients with Chronic Myelogenous Leukemia (CML), and 96 patients with  other myeloproliferative neoplasms (OMPN), were treated with Anagrelide in three clinical trials. Patients with OMPN  included 87 patients who had Myeloid Metaplasia with Myelofibrosis (MMM), and 9 patients who had unclassified  myeloproliferative neoplasms.

Patients were enrolled in clinical trials if their platelet count was ≥900,000/µL on two occasions or ≥650,000/µL on two  occasions with documentation of symptoms associated with thrombocythemia. The mean duration of Anagrelide therapy  for ET, PV, CML, and OMPN patients was 65, 67, 40, and 44 weeks, respectively; 23% of patients received treatment for  2 years. Patients were treated with Anagrelide starting at doses of 0.5-2.0 mg every 6 hours. The dose was increased if the  platelet count was still high, but to no more than 12 mg each day. Efficacy was defined as reduction of platelet count to or  near physiologic levels (150,000-400,000/µL). The criteria for defining subjects as “responders” were reduction in platelets for at least 4 weeks to ≤600,000/µL, or by at least 50% from baseline value. Subjects treated for less than 4 weeks were not  considered evaluable. The results are depicted graphically below:


† Nine hundred and forty-two subjects with myeloproliferative neoplasms were enrolled in three research studies. Of these,  923 had platelet counts measured over the duration of the studies.

Anagrelide was effective in phlebotomized patients as well as in patients treated with other concomitant therapies including  hydroxyurea, aspirin, interferon, radioactive phosphorus, and alkylating agents.  

FDA,2021.10

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