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Drug finding to save millions of pounds
Tuesday, 19 July 2005

Essential thrombocythemia (ET) is a rare disorder characterised by over-proliferation of certain types of blood cell which can lead to an increased risk of leukaemia, haemorrhage and thrombosis in patients. Typically, treatment involves taking two drugs: hydroxyurea and low-dose aspirin. Professor Tony Green and colleagues at the University of Cambridge and Addenbrookes Hospital(1) have completed a large-scale randomised study comparing the benefits of the old-style therapy with its newer alternative – a new drug called anagrelide which is allegedly more effective at treating ET.

Despite the new ‘anagrelide plus aspirin’ combined therapy being more expensive than its traditional counterpart, it appeared to be significantly less effective at controlling arterial thrombosis, serious haemorrhage and cellular transformation – when cells switch from non-cancerous to cancerous forms. Moreover, subjects on the novel drug were more likely to withdraw from the treatment due to unwanted side-effects. The authors of the study concluded that as the older approach involving hydroxyurea administration was preferable from both therapeutic and economic points of view, it should continue to be used as the first line of defence in treating ET in subjects vulnerable to thrombosis, a move that could save the government millions of pounds a year.

(1) Harrison et al. (2005) Hydroxyurea compared with anagrelide in high-risk Essential Thrombocythemia New England Journal of Medicine 353:33-45.

 
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