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2024-11-25T08:38:30.000Z

Impact of a reduced starting dose of ruxolitinib on survival in patients with MF

Nov 25, 2024
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A retrospective analysis of a prospective observational cohort from AIFA Monitoring Registries assessed the association between the starting dose of ruxolitinib, an oral JAK1/2 inhibitor, and long-term outcomes in 3,494 patients with MF.1 Results from this analysis were published in the British Journal of Haematology by Breccia et al.1


Key learnings
Patients initiating ruxolitinib at reduced doses (n = 2,337) were generally older, with larger splenomegaly, higher IPSS risk, and worse ECOG scores.
After balancing for baseline characteristics, initiating ruxolitinib at a reduced dose was associated with a shorter median OS (52.6 months vs. 78.2 months; HR, 1.444; 95% CI, 1.296–1.609; p <0.001) compared with starting at the full dose.
Subgroup analysis indicated that the reduced starting dose affected OS in patients with intermediate-2 (HR, 1.491; 95% CI, 1.294–1.718; p <0.001) and high (HR, 1.398; 95% CI, 1.176–1.66; p <0.001) IPSS risk.
These findings show that, regardless of the baseline characteristics, a reduced starting dose of ruxolitinib was associated with worse survival outcomes in patients with intermediate-2 and high-risk MF. 

Abbreviations: AIFA, Agenzia Italiana del Farmaco; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; HR, hazard ratio; IPSS, International Prognostic Scoring System; JAK, Janus kinase; MF, myelofibrosis; OS, overall survival.

  1. Breccia M, Celant S, Palandri F, et al. The impact of starting dose on overall survival in myelofibrosis patients treated with ruxolitinib: A prospective real-world study on AIFA monitoring registries. Br J Haematol. 2024. Online ahead of print. DOI: 10.1111/bjh.19812

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