Rubin Mesa MD, Serge Verstovsek MD, Richard Silver MD, and Emily Knight R.N., O.C.N. provide their perspectives on the optimal use of cytoreductive therapies for PV. At present, there are no universal guidelines regarding the management of PV. Ruxolitinib was recently approved for PV patients who are resistant, refractory, or intolerant to hydroxyurea (HU).