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How might extended-release formulations of ruxolitinib benefit patients with MF?
Featured:
Do you know... Which of the following statements may be true of an extended-release formulation of ruxolitinib?
The MPN Hub was pleased to speak with Jennifer Vaughn, The Ohio State University Comprehensive Cancer Center, Columbus, US. We asked, How might extended-release formulations of ruxolitinib benefit patients with MF?
In this interview, Vaughn discusses the potential benefits of an extended-release ruxolitinib formulation for patients with myelofibrosis, noting that ruxolitinib’s short half-life necessitates twice-daily dosing, which may reduce adherence. Vaughn highlights that an extended-release formulation, enabling once-daily dosing, may improve adherence, maintain disease control, and lessen cytopenias.
How might extended-release formulations of ruxolitinib benefit patients with MF?
Key learnings
- Ruxolitinib is approved for the treatment of myelofibrosis (MF), including primary MF, post-polycythemia vera MF, and post-essential thrombocythemia MF in adults.1,2
- Ruxolitinib has a half-life of ~3 h and is therefore administered twice daily in order to maintain therapeutic efficacy.1,2
- Higher drug adherence rates have been observed with once-daily regimens compared with multiple dosing regimens.3
- In the Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera (RAMP) multicenter, prospective study (NCT06078319; N = 189), among the 42 patients who reported that they forgot to take ruxolitinib, 57% reported that this was due to the twice-daily regimen.4
- An extended-release formulation of ruxolitinib could enable once-daily dosing and may therefore increase patient adherence.
- Adherence to ruxolitinib is important for maintaining disease control and preventing side effects from missed doses, such as ruxolitinib discontinuation syndrome, which is characterized by re-expansion of splenomegaly and relapse of MF symptoms.4
- Cytopenias, including anemia and thrombocytopenia, are on-target side effects of ruxolitinib. An extended-release ruxolitinib formulation may lower the incidence of anemia and thrombocytopenia by reducing high peak plasma concentrations (cmax) associated with the short half-life.5
- Studies have demonstrated that, based on area under the curve parameters, extended-release ruxolitinib 50 mg tablets dosed once daily are bioequivalent to ruxolitinib 25 mg tablets dosed twice daily.6,7 However, an extended-release ruxolitinib formulation has yet to be approved for the treatment of MF.
This educational resource is independently supported by Incyte. All content was developed by SES in collaboration with an expert steering committee. Funders were allowed no influence on the content of this resource.
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A 68-year-old male with primary myelofibrosis received ruxolitinib 10 mg twice daily for 7 months. His spleen size and symptoms are controlled, but Hb remains <8 g/dL. EPO, 210 mU/mL; platelets, 85,000/µL. What is your next step?
