Every bug we fix we apply this as a PR. A few PRs from the repository we have cherry-picked internally and deployed. But we have also a few issues with it like this one here: https://github.com/twitter/twemproxy/issues/442 or live reconfiguration would be a nice feature. Think about it if you really need this, because it is not only fun. A few pain points:
* Deployments of new configs and restarting twemproxy on your server farm
* New redis version with new commands? Extend twemproxy for those command support
I don't now any _real_ alternative to it, right now. I know from https://github.com/Netflix/dynomite which is a twemproxy fork. When we had only memcached and no redis (we are using both with twemproxy), then we would try https://github.com/facebook/mcrouter from facebook. But it is specialized on memcached.
If you come up with an alternative, please let me know.