{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:48:18Z","timestamp":1779914898243,"version":"3.53.1"},"reference-count":21,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Novartis Israel Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Polycythemia vera (PV) is a chronic hematologic neoplasm commonly treated with hydroxyurea (HU). We utilized the advanced digitalized database of Maccabi Healthcare Services to retrospectively investigate the clinical and economic implications of HU intolerance in the routine clinical care of PV patients in Israel. Methods: We collected data on demographics, physician visits, hospitalizations, laboratory results, medication purchases, cardiovascular and thrombotic events, mental health, economic outcomes, and mortality. Outcomes included cardiovascular and other thrombotic events, disease progression, mental health events, economic outcomes, and overall mortality. Results: Of the 830 patients studied, 3 (0.4%) were resistant to HU treatment, 318 (38.3%) were intolerant to HU treatment, and 509 (61.3%) were stable on HU treatment. The venous thrombosis rate was significantly higher among HU-intolerant compared to HU-stable patients (1.58 vs. 0.47 per 100 person-years [PY], respectively; p &lt; 0.001). The rate of progression to myelofibrosis was 6 vs. 0.9 per 100 PY in HU-intolerant patients vs. HU-stable patients, respectively (p &lt; 0.001), and the rate of progression to acute myeloid leukemia (AML) was 1.16 vs. 0.2 per 100 PY in HU-intolerant patients vs. HU-stable patients, respectively (p &lt; 0.001). The phlebotomy requirement, mortality rate, and total hospitalization days among HU-intolerant patients were significantly higher than in HU-stable patients (p = 0.049, p &lt; 0.001, p &lt; 0.001, respectively). More mental health-related events were noted in HU-intolerant patients vs. HU-stable patients (p = 0.007), and the total healthcare cost ratio was 2.65 for the HU-intolerant patients compared with HU-stable patients. Conclusions: This study suggests that HU-intolerant patients are more likely to have worse outcomes than HU-stable patients, highlighting the need for the close monitoring of these patients for disease-related complications or progression.<\/jats:p>","DOI":"10.3390\/jcm13123390","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T08:59:06Z","timestamp":1718009946000},"page":"3390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Economic Implications of Hydroxyurea Intolerance in Polycythemia Vera in Routine Clinical Practice"],"prefix":"10.3390","volume":"13","author":[{"given":"Martin H.","family":"Ellis","sequence":"first","affiliation":[{"name":"Hematology Institute, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3435-8612","authenticated-orcid":false,"given":"Tamar","family":"Tadmor","sequence":"additional","affiliation":[{"name":"Hematology Unit, Bnai-Zion Medical Center, Haifa 3339419, Israel"},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naama","family":"Yekutiel","sequence":"additional","affiliation":[{"name":"Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv 6800003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5189-8995","authenticated-orcid":false,"given":"Gabriel","family":"Chodick","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv 6800003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moti","family":"Levy","sequence":"additional","affiliation":[{"name":"Flute of Light Patient Advocacy Group, Netanya 4265952, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giora","family":"Sharf","sequence":"additional","affiliation":[{"name":"Flute of Light Patient Advocacy Group, Netanya 4265952, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Ben Zvi","sequence":"additional","affiliation":[{"name":"Novartis Israel Ltd., Tel Aviv 6744129, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raanan","family":"Leef","sequence":"additional","affiliation":[{"name":"Novartis Israel Ltd., Tel Aviv 6744129, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2064-296X","authenticated-orcid":false,"given":"Oren","family":"Feine","sequence":"additional","affiliation":[{"name":"Novartis Israel Ltd., Tel Aviv 6744129, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Shavit","sequence":"additional","affiliation":[{"name":"Novartis Israel Ltd., Tel Aviv 6744129, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11864-018-0529-x","article-title":"Polycythemia Vera","volume":"19","author":"Spivak","year":"2018","journal-title":"Curr. 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