I transitioned from hydroxyurea to Besremi in February because hydroxyurea was not keeping my white cell count under control, and I read that hydroxyurea doesn't do much to reduce the risk of progression to myelofibrosis or leukemia.
Long term, it does not reduce the allele burden, which is the current metric in determining the overall progress of reducing the severity of the disease and reducing the risk for blood clots.
I started well with Besremi. Generally speaking, the drug itself is doing what it is supposed to do. In the first few months my allele burden went from 91 to 80 with no side effects. However as time went on I started having difficulty with the thigh injections. Three times after I removed the needle the Besremi remained on top of my skin. I believe that was caused by the large amount of fluid retention in my thighs caused by my blood pressure medication. My hematocrit has creeped up to over 46, and I don't think the Besremi is consistently getting to the right place. So an alternate place to inject the Besremi is the stomach, which should work better.
Another issue I have which has recently occured is dry flaky skin on my face, ears and scalp.
This is a side effect experienced by about 25% of Besremi users.
It hasn't gotten any better with using a special shampoo and face cream. I hope to see a dermatologist eventually.
They are in very short supply. Overall I am glad I switched to Besremi. I am expecting the results of a second allele burden test soon and expect good results.
I am going to be out of town on vacation for a couple of weeks in February, and keeping the Besremi cool will be an interesting challenge.