Purpose: To compare the hematologic response to ropeginterferon alfa-2b versus available therapies in patients with hydroxyurea-resistant or intolerant polycythemia vera (HU-R/I PV) using propensity-matched real-world data. Methods: This retrospective propensity-matched cohort study compared a single-arm clinical trial cohort with a historical control cohort from five Korean institutions. We included 36 HU-R/I patients from a prospective phase II trial (PV IIT, registration number KCT0006138) and 81 matched historical controls. Propensity score matching and weighted analyses balanced the baseline characteristics (age, sex, disease duration, hematologic parameters, and HU status).The primary endpoint was a complete hematologic response (CHR) at 48 weeks. Results: At 48 weeks, ropeginterferon alfa-2b achieved significantly higher CHR rates (52%; 95% confidence interval [CI]: 35–70%) than historical controls (15%; 95% CI: 8–27%; odds ratio 0.15; 95% CI: 0.07–0.33; p < 0.0001). This superiority remained consistent across various matching ratios and weighted analyses. Subgroup analyses showed higher response rates to ropeginterferon alfa-2b, regardless of HU status (resistant vs. intolerant), age (< 60 vs. ≥ 60 years), or disease duration (< 5 vs. ≥ 5 years). In the control group, the most common regimen was a combination of HU and phlebotomy (53%) with limited use of ruxolitinib (5.5%). Analyses confirmed robustness with no significant baseline imbalances after matching. Conclusion Ropeginterferon alfa-2b demonstrated superior early hematologic efficacy compared with conventional salvage therapies in Korean patients with HU-R/I PV. Extended follow-up is warranted to assess the long-term clinical benefits.

Background: Previous studies have suggested that patients with polycythemia vera (PV) who exhibit hydroxyurea-resistance (HU-R) and -intolerance (HU-I) may have distinct characteristics and clinical outcomes. However, to date, no studies have reported a comparison between these two groups or assessed prognostic factors in these patients. Methods: The objective of this study was to evaluate clinical outcomes and identify prognostic factors among PV patients with HU-R or HU-I. We conducted a review of PV patients who received frontline treatment with HU from nine centers and identified 90 patients with HU-R or HU-I. Results: The cumulative incidence of thrombosis after 7 years of HU-R/I was 21.4%, and the incidence of disease progression was 22.5%. Comparing the HU-R and HU-I groups, the HU-R group had a significantly higher rate of disease progression (36.7% vs. 0.56%, P = 0.009), while there was no significant difference in thrombosis incidence (19.0% vs. 22.9%, P = 0.463). Multivariate analysis revealed that HU-R was an independent prognostic factor for progression-free survival (hazard ratio, 6.27, 95% confidence interval, 1.83–21.47, P = 0.003).Additionally, higher lactate dehydrogenase levels, multiple cardiovascular risk factors, and prior thrombosis were identified as unfavorable predictors of overall survival. Conclusion These findings suggest that patients with HU-R face a higher risk of hematological transformation, but have a comparable risk of thrombosis to patients with HU intolerance. These distinctions should guide decisions on second-line treatment options and clinical trials involving these patients.

BACKGROUND: The initial history, physical examination, and ECG assessment should focus on identification of potentially serious noncardiac or cardiac disorders, including coronary artery disease, congestive heart failure, and electrical instability at the emergency room. additionally, it is essential to define disease severity, stability and need for emergency therpy. echocardiography is a useful tool for this purppose. especially Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic symptoms. So we evaluate the feasibility of the echocardiographic measurement by emergency physicain after short-term course. METHOD AND RESULTS: Twenty volunteers(10 male, 38.8+/-9.3 years) were included in the study for measurement of myocardial performance index and established parameters of ventricular function using conventional echo-Doppler methods. Myocardial performance index: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The most of mean values of echocardiogrphic parameters were not significantly different between those of cardiologist and those of emergency physicians(p<0.01). The duration for measuring myocardial performance index was shortest among echocardiographic parameters. the validity of echocardiographic parameters measured by emergency physicians was proved relatively good. CONCLUSION: It is proved to be feasible for emergency physician to perform echocardiographic evaluation of ventricular function after short-term course.
Coronary Artery Disease ; Curriculum* ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Heart Failure ; Humans ; Male ; Physical Examination ; Relaxation ; Ventricular Function*