Older drug better than new for blood cell disorder

July 7, 2005

By Gene Emery Wed Jul 6, 5:10 PM ET

BOSTON (Reuters) - The older generic drug hydroxyurea, if combined

with a small dose of aspirin and given to people with thrombocythemia,

is more effective in preventing serious bleeding and other

complications than the newer and more expensive Agrylin, according to

a study.

Agrylin, also known as anagrelide, is made by Pharmaceuticals,

which merged with Shire Pharmaceuticals Group in 1999.

Thrombocythemia occurs when too many blood-clotting structures known

as platelets are produced in the bone marrow. It can affect other

types of blood cells and can cause a host of problems including chest

pain, bleeding, and leg and lung clots. It usually strikes in middle

age, affecting 1 in 30,000 people.

Although hydroxyurea has been a mainstay treatment for years, there

have been concerns that it might cause leukemia. The effectiveness of

Agrylin, which is a more expensive alternative, has not been well

tested until now, according to the authors of a study published in

Thursday's

New England Journal of Medicine.

At 138 centers in the United Kingdom, Ireland and Australia, a group

led by on of the University of Cambridge followed more

than 800 volunteers for an average of 39 months. It found that Agrylin

recipients were 57 percent more likely to suffer serious problems

connected with thrombocythemia.

Agrylin recipients were nearly six times more likely to suffer a small

stroke, and 3 1/2 times more at risk of developing serious stomach

bleeding than those who were administered hydroxyurea.

In addition, " patients receiving anagrelide were more likely to

withdraw from their assigned treatment " because of side effects,

on and her colleagues reported.

The results were so dramatic, the study was halted early so doctors

could be informed of the findings.

In a Journal editorial, Tiziano Barbui and Guido Finazzi of Ospedali

Riuniti in Bergamo, Italy, said " for now, hydroxyurea plus aspirin

should be the standard of treatment for patients with essential

thrombocythemia " whose disease makes them vulnerable to blood clots.

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