In October 2026, an article was published in the Lancet (eClinicalMedicine) explaining results of the Phase 3 clinical trial comparing interferon alpha (available in Australia as Pegasys) with hydroxyurea (also known in Australia as Hydrea or hydroxycarbamide).
The article is free to access in full. Interferon-a vs hydroxyurea in patients with myeloproliferative neoplasms (DALIAH): a multicentre, randomised, open-label, phase 3 trial in Denmark
The Research in context component of the article is directly quoted below.
“Evidence before this study
Hydroxyurea (HU) has long been the standard first-line cytoreductive therapy for patients with myeloproliferative neoplasms (MPN). However, emerging evidence suggests a disease-modifying potential of interferon-alpha (IFNa), with recent data linking molecular response to improved progression-free survival. When the DALIAH trial was initiated, no other phase 3 randomised studies had directly compared HU with pegylated IFNa in MPN. Subsequent trials, including CONTINUATION-PV, MPD-RC 112, and Low-PV, have provided additional evidence in polycythaemia vera or essential thrombocythaemia, but DALIAH remains the earliest and largest randomised trial to evaluate long-term pegIFNa therapy in newly diagnosed MPN across all subtypes.”
“Added value of this study
DALIAH provides five-year, randomised, head-to-head data comparing HU with low-dose pegylated interferon-alpha2 (pegIFNa), either pegIFNa-2a or pegIFNa-2b, in patients with MPN. Among patients tolerating therapy, pegIFNa achieved superior long-term molecular responses, while HU showed earlier clinicohaematological and greater long-term histopathological responses. Discontinuation was significantly more frequent with pegIFNa than with HU; severe adverse events were similar, highlighting distinct response kinetics and tolerability.”
“Implications of all the available evidence
These results demonstrate long-term molecular superiority among patients who tolerate pegIFNa. Findings should be considered within the context of the higher treatment discontinuation rate with pegIFNa than with HU. Taken together with recent evidence linking molecular response with improved event-free survival, the DALIAH trial suggests that pegIFNa may represent a viable first-line cytoreductive therapy for selected patients with newly diagnosed MPN, underscoring the need for biomarkers that predict both response and long-term tolerability, ideally at diagnosis. Although pegIFNa-2b has subsequently been withdrawn from the European Union market, pegIFNa-2a remains available, and mono-pegylated IFNa-2b (ropeg) has expanded the therapeutic options for interferon treatment in MPN.”
