Rusfertide and Givinostat in Clinical Practice

This section examines how emerging agents such as rusfertide and givinostat may reshape the polycythemia vera treatment paradigm. Faculty emphasize that these agents should not be viewed as competitors but rather as therapies with distinct and potentially complementary mechanisms. Rusfertide targets iron regulation by mimicking hepcidin, offering a strategy to maintain hematocrit control while reducing the need for repeated phlebotomies. This approach directly addresses iron deficiency driven symptoms and treatment burden. In contrast, givinostat functions as a histone deacetylase inhibitor and is positioned closer to cytoreductive therapies such as hydroxyurea or interferon, with potential effects on blood counts and disease biology. The discussion highlights that PV remains a disease with very limited approved options, underscoring the need for additional well tolerated therapies. Given the chronic nature of PV, tolerability and long term adherence are critical considerations. Faculty stress that patients often require therapy for decades, making safety and quality of life central to treatment selection. The experts also note that different patients may benefit from different mechanisms depending on symptom profile, disease activity, and treatment history. The availability of multiple agents with diverse targets would allow clinicians to individualize care more effectively. This segment reinforces the idea that expanding the therapeutic armamentarium is essential for improving outcomes and addressing unmet needs in PV management.