For ET due to CAl-R mutation, I was OK on HU for about 3 years, when it was only one pill per day, but had evil digestive issues during the next year, when it was increased to a second pill some days of the week. I switched last December to a hematologist who is also an MPN specialist. He had me gradually changing over a six month period from HU to Anagrelide, which has meant the end of the messy diarrhea. He told me that HU is the drug of first choice but if people have problems with it, Anagrelide may work better. That's been true for me. I had read about Interferon and Besremi on this site so asked about them. I'm not sure why, but he prefers Anagrelide for me.

For example; why be given hydrea vs the highly researched and effective interferon?

I think they use Hydrea for cost. I’ve heard the newer treatments are very expensive. My mother had PV 24 years ago and it was controlled with Hydrea. I am taking it for ET.

I do not believe that they have received FDA approval for use of ropeinterferon/Bestemi for ET yet. I know there are clinical trials for it.

I am confused. Can you explain what the old routine is vs the best treatment?