Faheema Hasan/LinkedIn
Sep 2, 2026, 14:07
Faheema Hasan: A New Second-Line Therapy for Essential Thrombocythemia
Faheema Hasan, Associate Professor at United Medicity, shared a post on LinkedIn:
“FDA Approves Besremi (ropeginterferon alfa) for Essential Thrombocythemia as second line after hydroxyurea, the first new drug in ET after nearly 3 decades.
Not only does it provides improvement in platelet counts but it also decreases JAK2 mutational burden proving its disease modifying effect as well…
Key points from the approval:
- Dosing: Starts at 250 mcg SC, stepped up to 350 mcg at 2 weeks, then a maintenance dose of 500 mcg every 2 weeks (adjusted for tolerability)
- Evidence base: The SURPASS ET trial compared Besremi to anagrelide in 174 adults with ET who had an inadequate response to or intolerance of hydroxyurea
- Efficacy: Durable modified ELN response (blood count remission plus stable/improved spleen size plus no bleeding/clotting events) was seen in 37.4 percent of Besremi-treated patients versus 3.6 percent on anagrelide at both 9 and 12 months
- Safety: Most common adverse effects were transaminase elevation, anemia, fever, bacterial infection, pruritus, and weight loss
This gives us another evidence-backed second-line option for ET patients who don’t respond well to or can’t tolerate hydroxyurea — an interferon-based therapy with a meaningfully higher durable response rate than anagrelide in this setting.”

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