There are also anagrelide, Pegasys, and Jakafi. Anagrelide has been around a long time, but causes heart issues for some. Peg and Jakafi are newer, it generically available, and stilloff-label for ET, so really expensive and not always covered by insurance. Peg is interferon based and MAY sometimes lead to remission, but has more side effects than HU. Jakafi inhibits the gene that causes ET, but has not turned out to he the godsend everyone thought. Other similar drugs are being tinkered with, and something may come of those. I think it's now mostly used when HU fails.