Hematologic and molecular response to ropeginterferon alfa-2b in patients with polycythemia vera: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Progressive increase in CHR from 19% at 3 months to 73% at 36 months

• Primary Outcome: Complete hematologic response (CHR) at 36 months: 73% (95% CI: 17-97%)

• Nnt Or Sensitivity: JAK2V617F VAF reduction of -54.90% (95% CI: -65.61 to -43.99%) at 36 months

• Confidence Interval: 95% CI: 0.17-0.97 for CHR at 36 months

Clinical Application

Requires specialist hematology care and regular monitoring for molecular responses Would require TGA approval and PBS listing consideration. Fits within RACGP guidelines for specialist referral of myeloproliferative neoplasms Patients with polycythemia vera suitable for interferon therapy

Abstract

Ropeginterferon alfa-2b is an interferon used in the treatment of myeloproliferative neoplasms, particularly polycythemia vera. Its efficacy in achieving hematologic and molecular responses has been demonstrated in clinical trials, but pooled data on long-term outcomes and sustained response remain limited. This systematic review and meta-analysis aimed to evaluate the hematologic and molecular response over 36 months. PubMed, Scopus, Science Direct, and Google Scholar databases were searched to identify studies reporting hematologic and molecular responses to ropeginterferon alfa-2b. Studies were included if they provided data on complete hematologic response (CHR) and JAK2V617F variant allele frequency (VAF) reduction. Pooled proportions and mean reductions were calculated using random-effects models. The pooled proportion of CHR increased progressively from 0.19 (95% CI: 0.04-0.57) at 3 months to 0.73 (95% CI: 0.17-0.97) at 36 months. Molecular response, measured by VAF reduction, deepened over time from - 7.33 (95% CI: -9.85 to -4.81) at 3 months to -54.90 (95% CI: -65.61 to -43.99) at 36 months. Subgroup analyses revealed significant variability in response rates, particularly in early follow-up periods. Ropeginterferon alfa-2b achieves significant and sustained hematologic and molecular responses over 36 months. This makes it a promising treatment for polycythemia vera. While variability in early responses needs further investigation, the sustained long-term efficacy compared to hydroxyurea supports its use in clinical practice. Future studies should focus on identifying predictors of response and optimizing treatment protocols to maximize patient outcomes.

References

1. 1.Elgadi, A., Wagealla, M., Noorallah, T., Esmail, R., & Almahi, S. S. (2026). Hematologic and molecular response to ropeginterferon alfa-2b in patients with polycythemia vera: a systematic review and meta-analysis. Annals of Hematology. https://doi.org/10.1038/sj.leu.2404854