Anagrelide works by inhibiting the maturation of platelets from megakaryocytes.

A phosphodiesterase inhibitor.

Trade name Agrylin

Used to treat essential thrombocytosis, especially when the current treatment of the patient is insufficient.

Useful in essential thrombocytosis in patients over 60 years of age, with a platelet count over 1000×109/L and a history of thrombosis.

A Medical Research Council randomized trial, the combination of hydroxyurea with aspirin is superior to the combination of anagrelide and aspirin for the initial management of ET.

In the above study hydroxyurea arm has a lower likelihood of the development of myelofibrosis, arterial thrombosis, and bleeding, but it had a slightly higher rate of venous thrombosis.[

Can be useful in times when hydroxyurea proves ineffective.

Side effects are headache, diarrhea, unusual weakness/fatigue, hair loss, nausea and dizziness.

Associated with a rapid increase in the degree of reticulin deposition, when compared to hydroxyurea.

Patients with myeloproliferative have a slow and variable course of marrow fibrosis progression which may be accelerated by anagrelide.

Increases in fibrosis are linked to a drop in hemoglobin, and stopping the drug and changing to hydrxyurea appeares to reverse the degree of marrow fibrosis.

Patients on anagrelide may need to be monitored on a periodic basis for marrow reticulin scores.

Less common side effects include: congestive heart failure, myocardial infarction, cardiomyopathy, cardiomegaly, complete heart block, atrial fibrillation, cerebrovascular accident, pericarditis, pulmonary infiltrates, pulmonary fibrosis, pulmonary hypertension, pancreatitis, gastric/duodenal ulceration, renal impairment/failure and seizure.

Due to above problems anagrelide is not considered for first line therapy in ET.

Associated with cardiomyopathy. .

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