Do you recommend GLP-1 agonists in patients with MPN?

I don't think that there is a compelling reason to start a GLP-1 agonist without another indication. With that said, there was a provocative recent abstract at SOHO suggesting a significant reduction in mortality, thrombosis, and disease progression in GLP-1-treated PV patients compared to those who were not (Clinical Lymphoma, Myeloma and Leukemia, 2025). There are many methodological limitations to this analysis, but if a patient has an indication for a GLP-1 agonist, I think this data suggests there may be additional benefits.

I agree with Dr. @Dr. First Last, although the data presented at SOHO were very provocative, demonstrating benefits to GLP-1 agonists in MPN patients, we do not currently have any prospective data or consensus guidelines to recommend the use of these agents for MPN alone.

That being said, anecdotally, I have several patients on these medications that are finally able to lose weight despite being on ruxolitinib, an agent that is known for weight gain, and thus think this would be an interesting population to study as well!

Like with other CV risk management, I see the MPN as one more indication for more aggressive BP, cholesterol, and A1c management, but not an indication alone to change/start therapy.